Pharmacy Providers for Assisted Living


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The ALPhA Advantage
Providers	Understands Assisted Liiving Care	Superior Medication Management	Competitive Buying Power	National Sales & Marketing	Nationwide Coverage
National Nursing Home Providers	No	Few	Yes	Yes	Yes
Local Assisted Living Providers	Yes	Some	No	No	No
ALPHA Members	Yes	Yes	Yes	Yes	Yes

Please answer the following questions to help us evaluate your qualifications to become an ALPhA Certified pharmacy. We also will require references from at least three of your communities. (The information you provide will be kept private and will be used only by ALPhA to evaluate your qualifications to become ALPhA Certified).

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Contact Name:		*
Email:		*
Phone:		(###-###-####) *
Fax:		(###-###-####)
Do you have a specific focus on Assisted Living:		Yes No *
What precent of your business is Assisted Living:		*
How many residents are you currently servicing:		*
Are you a closed door pharmacy:		Yes No *
Do you offer a medication management training program for communities:		Yes No *
Do you offer medication administration records:		Yes No *
Do you offer consulting services:		Yes No *
Do you offer carts and fax machines:		Yes No *
Do you have STAT medication plan in place for communities:		Yes No *
Do you deliver:		Yes No *
Deliver between what hours:
Do you bill third party insurance:		Yes No *
Do you bill on a monthly basis for cash paying residents:		Yes No *
Do you offer multi-dose packaging:		Yes No *
What packaging systems do you offer:
What is your pharmacy system:
How did you find our Web Site:

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