SCHEDULE 3  PART II  NOTIFICATION OF COMMENCEMENT DATE

general

TO THE  .............................................................................................................................................................

FHSA

1. The application which

I/We .......................................................................................................................

of    .........................................................................................................................

made on...................................................................................................................

was granted on.........................................................................................................

2.     The application related to premises at .................................................................

...............................................................................................................................

...............................................................................................................................

3. The services I/we are entitled to provide are.........................................................

...............................................................................................................................

...............................................................................................................................

4. I/We intend to commence provision of those services at

those premises on ...................................................................................................

...............................................................................................................................

5.     Those premises have been registered by the Royal Pharmaceutical Society of Great Britain

     Reference No  .................................................................................................              

6.     The pharmacist in charge at those premises will be

Name .............................................................................................................

Registration No...............................................................................................

7.     I/We undertake to provide the said services under the terms of service for the time being in

     operation by the FHSA.

Signed.......................

     Date.........................

*The sections or words which do not apply should be deleted as necessary.

Book Title: Pharmaceutical Regulations