Add Drug to Hospital Formulary Request
Request Addition of a Drug to the Presbyterian Hospital Formulary
This form is for Presbyterian physicians and practitioners to request additions to Presbyterian Hospital's formulary. There is a separate form to request an addition to the Presbyterian Health Plan formulary
(All fields are required, except Comments)
Once all material for the request for addition of a drug to the Presbyterian Hospital Formulary has been received, your request will be placed on the next available agenda for the Pharmacy and Therapeutics Committee.
The Committee meets bi-monthly on the third Wednesday at 1230.
You will be contacted in advance of the meeting by a Pharmacy Clinical Services representative to discuss your request, which you are required to present to the Pharmacy and Therapeutic Committee.
You will be notified after the committee has made a recommendation on your request.
If you prefer to send this form, you may print, fill out and send it to:
Rachel Hroncich, PharmD
Presbyterian Hospital Pharmacy
PO Box 26666
Albuquerque, NM 87125-6666