Protocol · PharmD · Virginia
Practice Protocol for Pharmacists in Virginia
Required. Virginia law names the instrument a Written Collaborative Agreement, and the clinical protocol is the content that instrument carries. Below: the board that governs it, what it must contain, and the terms it has to carry.
Represents Virginia's pharmacist Collaborative Practice Agreement (CPA) tier, not ordinary licensure — base dispensing and statutory limited authority need no physician agreement and are out of scope here. Unlike NC, VA has no named credential and no board-certification/residency/experience requirement — any licensed pharmacist 'involved in patient care' may enter a CPA. No numeric cap per physician was found. Regs were amended effective Nov. 5, 2025 — that amendment's substance couldn't be fully confirmed; verify before treating details below as current.
What a Virginia Written Collaborative Agreement must contain
Governed by the Virginia Board of Pharmacy. Each numbered item is a statutory requirement the Written Collaborative Agreement must satisfy.
The Pharmacist shall practice pursuant to a written collaborative agreement with the Physician, as required by Va. Code § 54.1-3300.1, defining cooperative procedures for treatment using drug therapy, laboratory tests, or medical devices, for the purpose of improving patient outcomes. The collaborative agreement may authorize the Pharmacist to prescribe, modify, continue, or discontinue drug therapy, order laboratory tests, or otherwise manage or monitor drug or device therapy, but only for conditions with protocols that are clinically accepted as the standard of care or approved by the Virginia Boards of Medicine and Pharmacy, and only after diagnosis by the Physician or another licensed practitioner authorized to diagnose.
Source: Va. Code § 54.1-3300.1
Before the Pharmacist prescribes, modifies, continues, or discontinues a Schedule II through V controlled substance under the collaborative agreement, the Pharmacist shall submit a signed copy of the agreement to the Virginia Board of Pharmacy and obtain the Board's authorization for that activity. No collaborative agreement may exceed the scope of practice of either Party, and no patient may be required to participate in a collaborative procedure without the patient's consent.
- The Written Collaborative Agreement also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.
Statutes and rules these clauses cite
- Va. Code § 54.1-3300.1statute
Authorizes pharmacist-practitioner collaborative agreements for drug therapy, lab test, and device management, including Board of Pharmacy authorization required before prescribing Schedule II-V controlled substances under such an agreement.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the Written Collaborative Agreement has to carry, from Virginia's supervision rules.
Proximity
Not codified — left to the agreement
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
May prescribe, modify, continue, or discontinue drug therapy per protocol following diagnosis by the collaborating practitioner, order labs, and adjust/manage device therapy (§ 54.1-3300.1). Schedule II–VI controlled substances are explicitly authorized, but only after the pharmacist submits the signed CPA to the Board of Pharmacy and obtains specific authorization — not automatic.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — No pharmacist-ownership requirement — § 54.1-3434 expressly allows non-pharmacist/corporate pharmacy ownership; a licensed pharmacist-in-charge (PIC) must retain full professional control over dispensing, which the owner 'shall not abridge.'
Materially more permissive than the healing-arts/APRN PC/PLLC regime above.
About Virginia's rules
No provider type below has a codified chart-review percentage, countersignature rule, or numeric proximity radius — all are left to the practice agreement. CPOM (ownership) is governed by Title 13.1's PC/PLLC statutes, which explicitly list APRNs (NP/CRNA/CNM/CNS) as eligible independent owners but do not enumerate PAs — the PA ownership pathway is an inference from that omission, not a confirmed holding. Virginia has no independent corporate-practice-of-medicine common-law doctrine (a 1992 AG opinion, secondary-sourced only).
Other clinicians in Virginia: see the state overview.