Pharmacy Immunization Protocol | PharmCompliance
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Pharmacy Immunization Protocol

Pharmacy Immunization Protocol


Easily create a collaborative practice agreement and begin giving vaccines! Don't miss out on this top revenue opportunity.

  • This template is all you need to create a collaborative practice agreement with a physician so you can begin giving vaccines. A protocol of this nature is required in many states, although it may go by different terms (like standing order or protocol).


    Comes as a Word file so you can edit it for your site. 5 pages total.


    Sections include:

    • Eligible patients
    • Pharmacist requirements
    • Patient monitoring
    • Reporting
    • Physician review of administration
    • Appendix A: Pharmacists authorized under the protocol
    • Appendix B: Pharmacists with authorization revoked under the protocol

    Each download allows for the copy and use of the form for one pharmacy permit.

    NOTE: This form is intended as an aid only and Pharmacy Compliance Specialists, LLC, shall not be held liable for damages resulting from the use or misuse of this product. 

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