Authorized Representative Role Selection
Please select the option below that best describes your role and press Continue.
   Authorized Representative of an Outpatient Pharmacy - For the purposes of this REMS outpatient pharmacies include but are not limited to retail, specialty, mail order, and closed system pharmacies. An authorized representative of an outpatient pharmacy is responsible for ensuring certification of the pharmacy in the Bosentan REMS Program. The authorized representative is also responsible for coordinating the activities required for the pharmacy and pharmacy staff in the Bosentan REMS Program.

   Authorized Representative of Chain Pharmacy Headquarters - For the purposes of this REMS chain pharmacies are retail pharmacies with multiple locations that dispense bosentan for outpatient use and have a pharmacy headquarters that coordinates pharmacy enrollment in the Bosentan REMS Program. The authorized representative of a chain pharmacy headquarters is responsible for ensuring certification and training in the Bosentan REMS Program for a corporate pharmacy contracted to participate with a pharmacy network provider. The authorized representative is also responsible for reporting confirmation of pharmacy dispensing location training to the Bosentan REMS Program.

   Authorized Representative of Inpatient Pharmacy - For the purposes of this REMS inpatient pharmacies include but are not limited to pharmacies in hospitals, hospices, long-term care facilities, and prisons. An authorized representative of an inpatient pharmacy is responsible for ensuring certification and training of the pharmacy location, training of the pharmacy staff, and audit readiness.
Authorized Representative of a Chain Pharmacy Headquarters
Based on the response selected, please confirm you are certifying for a Chain Pharmacy Headquarters



For the purposes of this REMS chain pharmacies are retail pharmacies with multiple locations that dispense bosentan for outpatient use and have a pharmacy headquarters that coordinates pharmacy enrollment in the Bosentan REMS Program. The authorized representative of a chain pharmacy headquarters is responsible for ensuring certification and training in the Bosentan REMS Program for a corporate pharmacy contracted to participate with a pharmacy network provider. The authorized representative is also responsible for reporting confirmation of pharmacy dispensing location training to the Bosentan REMS Program.

If the pharmacy you are certifying does not meet the definition of a chain pharmacy, please press Cancel to change your response; otherwise, please press Confirm to continue with the certification.


 
Authorized Representative of an Outpatient Pharmacy
Based on the response selected, please confirm you are certifying for an Outpatient Pharmacy



For the purposes of this REMS outpatient pharmacies include but are not limited to retail, specialty, mail order, and closed system pharmacies. An authorized representative of an outpatient pharmacy is responsible for ensuring certification of the pharmacy in the Bosentan REMS Program. The authorized representative is also responsible for coordinating the activities required for the pharmacy and pharmacy staff in the Bosentan REMS Program.

If the pharmacy you are certifying does not meet the definition of an outpatient pharmacy, please press Cancel to change your response; otherwise, please press Confirm to continue with the certification.


 
Authorized Representative of an Inpatient Pharmacy
Based on the response selected, please confirm you are certifying for an Inpatient Pharmacy



For the purposes of this REMS inpatient pharmacies include but are not limited to pharmacies in hospitals, hospices, long-term care facilities, and prisons. An authorized representative of an inpatient pharmacy is responsible for ensuring certification and training of the pharmacy location, training of the pharmacy staff, and audit readiness.

If the pharmacy you are certifying does not meet the definition of an inpatient pharmacy, please press Cancel to change your response; otherwise, please press Confirm to continue with the certification.


 

For additional information about the Bosentan REMS Program, please call 1-866-359-2612.