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Iowa Board of Pharmacy

6200 Park Ave, Ste 100 Des Moines, IA 50321


Request for Inspection of a Nonresident Pharmacy to be Completed by the Iowa Board of Pharmacy

This form is intended for nonresident pharmacies to request the completion of an inspection by an Iowa Board of Pharmacy compliance officer.

Requests by nonresident pharmacies that do not hold a current/active Iowa nonresident pharmacy license are required to submit a completed nonresident pharmacy license application, including all required attachments and required nonrefundable fees, before the request will be processed.

Once the pharmacy licensing specialist has received the request to complete an inspection, the request will be assigned to a compliance officer (CO).

The assigned CO will contact you to provide a cost estimate.

Costs shall include the following:

  • All costs associated with travel; including transportation, meals and hotel, and or virtual inspection
  • Compliance officer work time, including time in transit
  • Administrative costs

Upon written confirmation to complete the inspection from an authorized representative of the pharmacy the assigned CO may schedule the inspection.  Please note, scheduling the inspection may be delayed due to state travel policy requirements.

Following completion of the inspection, the CO will issue an inspection report to the pharmacy and submit a copy to the Board office.  If the report requires a response to one or more deficiencies, the license will remain pending until the receipt of a satisfactory response and any other omissions on the application.The pharmacy will not be billed for any fees or costs above and beyond the net cost to the Board for performing the inspection.

If the CO, upon review of the nonresident pharmacy's response to any cited deficiencies, determines that additional time was spent on the inspection report/review/communications, the CO may submit to the director an additional invoice outlining the cost differences.

If the CO, upon review of the nonresident pharmacy's response to any cited deficiencies, determines that less time was spent on the inspection report/review/communications than originally estimated, the CO may submit to the director a credit memo outlining the cost differences.

I acknowledge the statutory authority of the Board to recover the costs associated with conducting this audit/inspection and agree to remit payment for the same within 30 days of receipt of the final invoice.

Pharmacy Address

Name of Pharmacist in Charge (PIC)

Is the Individual Completing this Request the PIC?

Should the Cost Estimate be Sent to the PIC?

Name of Individual Cost Estimate is to be Sent to

Does the pharmacy provide compounded preparations

Compounding Type