TX HHS Form 1061. Class D Pharmacy License Exemption Request

The Texas Health and Human Services (HHS) Form 1061, Class D Pharmacy License Exemption Request, is a crucial document for healthcare providers seeking to streamline pharmaceutical services. This form enables clinics to request exemptions from obtaining a Class D pharmacy license, allowing them to partner with referral pharmacies to provide essential medications to patients.

The purpose of this form is to facilitate cooperation between the agency/clinic and referral pharmacies, ensuring that patients can access necessary medications without additional barriers or costs. The form requires clinics to outline their pharmacy referral process, including the location of referral pharmacies, elimination of barriers, and measures to ensure patients do not incur extra costs. Additionally, clinics must provide justification for requesting an exemption and a signed Memorandum of Understanding (MOU) with the referral pharmacy.

The Texas HHS Form 1061 is essential for healthcare providers seeking to improve patient care by simplifying pharmaceutical services. By understanding the purpose, audience, and usage of this form, healthcare professionals can effectively navigate the process of requesting a Class D pharmacy license exemption and providing high-quality care to their patients.