VAWD Application Instructions
The VAWD accreditation process begins with completing the online application. The following instructions are included to help the applicant provide the correct information.
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The VAWD
application includes a list of VAWD criteria for which the National
Association of Boards of Pharmacy® (NABP®) requires documentation
demonstrating compliance. NABP reviews the
submitted documents and specifically look for certain policies and
procedures believed by NABP to be essential to meeting the intent
of the VAWD criteria. You will be notified if NABP finds any of the
submitted materials unacceptable or in need of clarification. When
requested, please send mocked-up forms with fictitious information
so that the data demonstrates how the form is actually used. Do not
send blank forms. Completed forms help NABP interpret how a form is
actually used.
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Authorization
and release forms for background checking must be completed and signed
by the individual whose criminal and financial background must be
checked. Contact VAWD staff for more information about the forms and
fees. Applicable background checks must be completed prior to any
awarding of accreditation.
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Legal Business
Name is the name that will appear on the listing of VAWD-accredited
facilities that NABP maintains.
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Web site
URL (if any) must be the Internet address for the wholesale distributor’s
(WD) home page.
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Contact
person will complete the application form, and will coordinate responses
and revisions to policies and procedures, if necessary, and will schedule
on-site surveys and will coordinate renewal of accreditation.
- Designated Representative (DR) oversees the
day-to-day operations of the WD facility.
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Name of
Business or Corporate Entity applies to any for-profit or not-for-profit
legal entity that owns or contracts for the WD’s services. It
is the controlling or parent company.
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Executive
Officers apply to officers, directors, and other persons who are in
charge of the operations of the WD facility.
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Major Investors
include silent partners, venture capitalists, and any person, partnership,
or corporation who directly or indirectly owns greater than 10% equity
position in the ownership or controlling interest of the WD organization
and/or greater than 10% voting interest in such organization.
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Please
ensure all supplemental documentation that is requested in the application
is submitted:
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Proof of surety bond in an amount of at least $100,000 (examples of acceptable proof include evidence of insurance, a statement showing that funds have been deposited in a trust account or financial institution, or an irrevocable letter of credit)
- Copies of general and product liability certificate of insurance
(certificate must indicate date of issuance and expiration, and type and amount of coverage)
- Organizational chart
- Corporate structure (not required, but please note if it was submitted)
- Facility staff
- Graphical layout of the Wholesale Distributor (WD) facility
- Brief description of the security alarm system
- Designated Representative (DR) resume
- Copies of inspection reports and notices
- State inspection report
- Drug Enforcement Administration (DEA) notices
- Copy of the lease agreement, property deed, or other document evidencing rightful ownership or possession of the property
- List of state WD and controlled substance licenses, and DEA licenses and registrations
- List of vendors with whom you do business (must include the City and State)
- Vendors – businesses from whom applicant is buying and/or obtaining prescription drug products
- Customers – businesses to whom applicant is selling and/or shipping prescription drug products
- Photo Submission Form for the DR (applicable for Indiana and North Dakota licensees only)
- Download the DR Photo Form if applying for IN or ND
- Photo not required if applying for other states
- Kroll Background Check Release Forms for:
- DR
- DR’s supervisor
- Owners/principals with greater than 10% ownership interest if company not publicly traded
- Authorized Distributor of Record (ADR) List
- Copies of policies and procedures evidencing compliance with the VAWD criteria, as set forth in the application. Please label each policy and procedure with the category number and criterion number (for example, “Recordkeeping 1a”)
Please note that NABP reserves the right
to share information with its member boards of pharmacy and appropriate
regulatory or law enforcement authorities concerning any denial of VAWD
accreditation to a VAWD applicant.
