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Non-Formulary Request
Completion of this form, along with all requested information, is required for the P&T Committee to consider a change in the formulary status of a drug at Huntsville Hospital. Completed requests will be reviewed and added to the P&T agenda within 8 weeks of submission. You will be notified of the date/time/location of the P&T Committee meeting at which your request will be considered so that you can present information to the Committee at that time. If this drug has been referred to the High Cost Drug Committee, the request will be reviewed by that Committee (rather than P&T) at the next available opportunity. Please do not use this form to request a non-formulary drug in an emergent situation – for this type of request, contact the clinical pharmacy specialist in your area or a member of the pharmacy leadership team. If you have questions concerning this process, please contact the HH Drug Information Center at 5-2154.