Forms
	To view or print forms, choose from the list below. Board forms are PDF files. If you don't have Adobe Acrobat Reader, download now.
	Print the form you need and then type or legibly complete the required data OR type in the required data and then print the form and complete required signatures. Each form instructs you to either fax or mail the completed form to the Board.
	Pharmacists BACKGROUND CHECK SUMMARY EFFECTIVE 3-24-2008 (revised 08/26/2009)(57K) Change of Employment (196K) Change of Address (180K) Change of Name (182K) Examination Application(437K) Continuing Pharmacy Education C.P.E. Report Form - 2009 (89K) Interns BACKGROUND CHECK SUMMARY EFFECTIVE 3-24-2008 (revised 08/26/2009)(57K) Change of Address (180K) Change of Name (182K) Intern Application (333K) Statement of Preceptor (381K) Practical Experience Affidavit (166K) Examination Application(437K) Terminal Distributors of Dangerous Drugs BACKGROUND CHECK SUMMARY EFFECTIVE 3-24-2008 (revised 08/26/2009)(57K) Change of Responsible Person (395K) Discontinuing Business Form (250K) Personnel List Form for NEW Limited Licenses (64K) Personnel List Form for RENEWAL of Limited Licenses (64K) Wholesale Distributors of Dangerous Drugs BACKGROUND CHECK SUMMARY EFFECTIVE 3-24-2008 (revised 08/26/2009)(57K) OUT OF STATE WHOLESALERS: Call the Ohio Board of Pharmacy office at 614-466-4143 for entire list of requirements. APPLICATION for CHANGES to Existing Wholesale Distributor of Dangerous Drugs License: Application and Instructions - includes forms for both wholesalers distributing controlled substances and those that do not (1.4K) Businesses that are applying for a Wholesale License for the FIRST TIME must call our office at 614-466-4143 for the correct applications,instructions, and background check forms. Change of Responsible Person (272K) Discontinuing Business Form (43.7K) Wholesale Distributors / Manufacturers of Controlled Substances BACKGROUND CHECK SUMMARY EFFECTIVE 3-24-2008 (revised 08/26/2009)(57K) OUT OF STATE WHOLESALERS: Call the Ohio Board of Pharmacy office at 614-466-4143 for entire list of requirements. APPLICATION for CHANGES to Existing Distributor/Manufacturer of Controlled Substances License: Application and Instructions - includes forms for both wholesalers distributing controlled substances and those that do not (1.4K) Businesses that are applying for a Distributor/Manufacturer of Controlled Substances License for the FIRST TIME must call our office at 614-466-4143 for the correct applications, instructions, and background check forms.
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	http://www.state.oh.us/pharmacy/forms.htm This page updated October 22, 2009