LTC Consulting

Consulting Services Request

Once we receive your request our pharmacy team will reach out to confirm the scope of the consulting services and schedule a time and date that works best for you. Your satisfaction is our priority, and we look forward to assisting you.
Community Name*
Community Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Community Point of Contact Name*

First NameLast name
Point of Contact Phone Number*
Please enter a valid phone number.
Point of Contact Email*
example@example.com
Schedule Your Consulting Services

Thank you for choosing Good Day Pharmacy for your consulting services. We look forward to working with you.

Please select the best day(s) of the week and times of day that work for your schedule. Next, select the type of consulting you wish to receive; be sure to read the descriptions of the consulting type you select to ensure it will meet your needs.

If you have any questions, please reach out to our pharmacy team at 970-461-9101
Best Day or Days of the Week (select all that work):*

MondayTuesdayWednesdayThursdayFriday
Best Time Of Day*

Morning (8 AM to 12 PM)Afternoon (12 PM to 6 PM)Any Time (8 AM to 6 PM)
Please provide any additional details as to time and date preferences for the consulting services
Type of Consultation Requested?*

Standard ConsultingAdvanced Consulting
Standard Consulting Services
(Medication Cart Audit and Medication Pass Observation)
- Examination of medication cart/room for outdated and improperly stored/labeled medications
- Observation and evaluation of medication pass
  - Advice and recommendations given in adherence to state compliance and regulatory rules
- Does NOT include any medication chart reviews or medication management
- Maximum of 2 hours on-site
Cost:

Included up to 2 times a year per community request
Advanced Consulting Services
(Medication Chart Reviews and Medication Management)
- Includes all aspects of 'Standard Consulting'
- Review of medication orders in conjunction to MAR/eMAR
- Review of MAR/eMAR in conjunction to medications in medication cart/room
- Review of medication profiles and recommendations
Cost:

$90 per hour

It is highly recommended to have a dedicated staff member assist the consultant to optimize on-site time
Additional Comments or Questions?
By signing below, I hereby acknowledge that our community will be charged at a rate of $90 per hour for any advanced consulting services and for any standard consulting requested beyond twice annually (per calendar year). I agree to these terms and authorize any associated charges.
Signature*

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Consulting Services Request