Rpsgb.org: Internet pharmacy logo

Internet pharmacy logo application form

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Home > Registration & support > Registration > Internet pharmacy logo application form

About you

Are you the pharmacy owner or superintendent pharmacist?

Pharmacy owner Superintendent pharmacist

Name of pharmacy owner or superintendent pharmacist

Registration number of pharmacy owner or superintendent pharmacist

Pharmacy premises registration number

Name of registered premises

Address of registered premises

Website URL

Contact e-mail address

Contact telephone number

Self-assessment form

A: Website content

1. Are the name of the owner of the business and the address of the pharmacy at which the business is conducted clearly shown?

Yes No

2. Where applicable, is the name of the superintendent pharmacist clearly shown?

Yes No

3. Is there information on how to confirm the registration status of the pharmacy and the pharmacist?

Yes No

4. Are details of the complaints procedure available?

Yes No

B: Security and confidentiality

5. Are systems in place to protect the confidentiality and integrity of all patient information?

Yes No N/A

C: Protecting patient choice

6. When providing internet pharmacy services can you confirm that you will not participate in any agreement with a prescriber or other person that limits patient choice? (this includes, for example, the direction of prescriptions)

Yes No N/A

D: Supplying medicines

Please select which of the following you currently supply via your website:

7. Non-prescription medicines

Yes No

8. Prescription-only medicines

Yes No

9. Controlled Drugs

Yes No

10. Medicines to overseas patients

Yes No

Please notify the Society's Inspectorate if there are any changes to the medicines (as listed above) that you supply online

If you do not sell or supply medicines via your website then proceed to Section F

11. Do you inform patients of the identity of the pharmacist assuming professional responsibility for the supply of medicines?

Yes No N/A

12. Do you obtain sufficient information about the patient and the condition(s) being treated to assess the suitability of the product for the intended user?

Yes No N/A

13. Are there mechanisms for the patient or carer to contact the pharmacist to discuss any queries?

Yes No N/A

14. Do you provide appropriate counselling for the patient or carer to contact the pharmacist to discuss any queries?

Yes No N/A

E: Record keeping

15. Do you maintain a verifiable audit trail from the initial request for a medicine through to its delivery to the patient?

Yes No N/A

16. Do you maintain records about the online consultations and the identity of customers who have been supplied with medicines via the internet?

Yes No N/A

17. Do you maintain records of the identity of the pharmacist who has assumed professional responsibility for supply of a medicine following an e-mail/online request to purchase?

Yes No N/A

F: Information and advice

18. Is all the advertising or publicity on your website legal, decent and truthful?

Yes No

Declarations

I confirm that I am the above named person, that the information I have provided is accurate, and that the website complies with the conditions for use of the logo, and with the Code of Ethics for Pharmacists and Pharmacy Technicians and relevant supporting standards and guidance documents, in particular, Professional standards and guidance for internet pharmacy services

I confirm that, if requested by the Society for legitimate reasons, I will remove the internet pharmacy logo from my website

I understand that the provision of false, inaccurate or misleading information could result in an allegation of misconduct made against me or the owner of the business

Please note: There is a £50 application fee for the internet pharmacy logo