Commissioned Corps of the U.S. Public Health Service

Pharmacist Professional Advisory Committee

NCPS Applications and Forms

In 2016, the Chief Pharmacy Officer of the United States Public Health Service tasked the NCPS Committee to align the program with the evolving health care transformation to support clinical pharmacists with an advanced clinical practice and their role in providing a higher level of comprehensive medication and disease state management services. This can also support clinical pharmacists credentialed and privileged through their local medical staff process. For this reason, beginning in August 2017, only pharmacists who provide more comprehensive care will be eligible for NCPS certification.

General Instructions for NCPS Applications:

  • Complete the National Clinical Pharmacy Specialists application and supply the requested supporting documents.
  • Utilize the NCPS Checklist.  This should help prevent sending an incomplete application.
  • Be sure your local protocol contains the required elements itemized in the Critical Elements Protocol Checklist.
  • Be sure the protocol you submit has been approved by the facility’s Medical Staff (not just one physician).  It is a good idea to present the protocol to the P&T Committee and/or the Medical Staff Executive Committee for approval.  The names and signatures on the protocols must include the Clinical Director (and/or Medical Staff President) and the Chief of Pharmacy Services.  In addition, the protocol should contain the date the protocol initially became effective and dates of reviews and/or revisions.
  • Your NCPS supervisor and/or supervising physician should complete the NCPS Letter of Attestation.
  • The NCPS Patient Encounter Log should be completed to document the required number of patient encounters.
  • Pharmacists are required to show documentation of being credentialed and privileged through local facility’s medical staff beginning January 2019.  If the pharmacist is not able to meet this requirement, a Credentialing and Privileging Waiver will be required which is located at the end of the application.


NCPS Certification Application

If you were initially certified prior to August 2017, you must complete the Certification Application:

NCPS Recertification Application

If you were initially certified after August 2017 under the revised criteria, you may complete the Recertification Application:

Additional Forms

Outcome Forms - Annual outcomes for each protocol/applicant seeking certification is mandatory to achieve initial/continued NCPS approval.

Page Last Modified on 7/23/2019

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