Self-Report

Pharmacy professionals and student pharmacists who question whether they are at risk of being unable to practice with reasonable skill and safety due to impairment, have the right (and obligation) to ask for help when they need it. By failing to do so, they put themselves and their patients at risk. If a complaint is made to the Board of Pharmacy by a colleague, patient, concerned family member, etc., filing a self-report could have the potential to avoid disciplinary action.

A self-report may include, but is not limited to the following situations:

  • Diversion or misappropriation of a prescription drug or device for the individual's personal use without proper medical authorization
  • Alcohol and/or drug related offenses
  • Mental and/or physical disability with chronic or debilitating nature
  • Experiencing anger management concerns

How Do You Self-Report

You may self-report by doing one of the following:

  • Fill out the online self-report form and submit electronically; OR
  • Print the self-report form and fax to a confidential fax number (515) 725-0642 or mail to Board of Pharmacy, Attn: IMP3, 400 SW 8th Street, Suite E, Des Moines, Iowa 50309-4686; OR
  • E-mail imp3@iowa.gov 

Printed from the website on September 23, 2020 at 1:28pm.