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Application for Inclusion in the Pharmaceutical List

man looking at application for Inclusion in the pharmaceutical lList

1. Guidance

We strongly recommend that you read the guidance notes below before completing the application form.

  • Guidance notes for Inclusion in the Pharmaceutical List (Including Minor or Temporary Relocation and Change of Ownership)
  • Guidance notes for Inclusion in or Amendment to the Dispensing Doctors List

Application forms can be downloaded in step 2 of the process.

Data Protection Notice

Data Protection Legislation covers the personal information provided by you on this Application Form. A Confidentiality Agreement, comprehensive training and specific Information Governance protocols govern all NHS staff that will process your information and this process is undertaken in a fair and lawful manner, only seen by those who require it for legal purposes. The personal information you provided is only used for compatible purposes and this will be in line with your expectations.

We will not knowingly release your personal details to any other organisation for any purposes without obtaining your explicit consent unless there is a justified, legal basis for doing so. However, this will be informed to you at the earliest possible stage.

If you would like any further information relating to the confidentiality of the information you provided, please contact the NWSSP Information Governance Manager on 02920 902272 , e-mail nwsspinformationgovernance@wales.nhs.uk or visit https://nwssp.nhs.wales/about-us/information-governance/

2. Application

The following forms are available for downloading:

  • AWP1 – Application for Inclusion in the Pharmaceutical List or for Preliminary Consent
  • AWP2 – Application for a Change of Ownership
  • AWP3 – Application for a Minor or Temporary Relocation
  • AWP4 – Application for Outline Consent to Dispense, Premise Approval or Relocation
  • AWP5 – Notification of Commencement
  • AWP6 – Schedule of Charges
  • AWP7 – Fitness – Contractor Details (Including Appliance Contractors)
  • AWP8 – Fitness Declaration
  • HN1 -   Notification of Opening Hours

We strongly recommend that you read the appropriate guidance notes before completing forms AWP1, AWP2, AWP3 and AWP4:

Guidance notes for Applications for Inclusion in the Pharmaceutical List.

Thank you for using the online application process.