FORMS (18VAC110-21).
Application for Licensure as a Pharmacist by Examination (rev. 3/2023)
Application for Licensure as a Pharmacist by Endorsement (rev. 3/2023)
Instructions for Reinstating or Reactivating a Pharmacist License (rev. 3/2023)
Instructions for Reinstating a Pharmacy Technician Registration (rev. 4/2023)
Application for Registration as a Pharmacy Technician (eff. 6/2021)
Affidavit for Limited-use Pharmacy Technician (rev. 5/2018)
Application for Approval of Pharmacy Technician Training Program (rev. 10/2020)
Application for Registration as a Pharmacy Technician Trainee (rev. 8/2023)
Application for Registration as a Pharmacy Intern (rev. 3/2023)
Affidavit of Practical Experience as a Pharmacy Intern (rev. 3/2019)
Name Change Form for Individuals (rev. 3/2018)
Application for Approval of a Continuing Education Program (rev. 10/2020)
Application for Approval of an Innovative (PILOT) Program (rev. 6/2021)
Application for Approval of a Repackaging Training Program (rev. 10/2020)
Continuing Education (CE) Credit Form for Preceptors (rev. 7/2020)
Sponsor Certification for Volunteer Registration (rev. 4/2018)
Application for Volunteer Practice by a Pharmacist (rev. 4/2018)
Continuing Education (CE) Credit Form for Volunteer Practice (rev. 4/2018)