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  - Pharmacists only NOT FOR BUSINESSES (180K) Change of Name - Pharmacists only NOT FOR BUSINESSES (182K) Examination Application(437K) Continuing Pharmacy Education "Change of C.E. Reporting Procedure Letters" were mailed April 12, 2012 to pharmacists who report this year -(licenses that begin with 033). Click here to view letter. Interns BACKGROUND CHECK SUMMARY EFFECTIVE 3-24-2008 (revised 08/26/2009)(57K) Change of Address - Interns only NOT FOR BUSINESSES (180K) Change of Name - Interns only NOT FOR BUSINESSES  (182K) Intern Application NEW ONLY NOT FOR RENEWAL (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 (42K) 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. 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. Wholesale Licensees that have a change of name, change of owner, change of category, or change of address must call our office at 614-466-4143 for the correct applications, instructions, and background check forms (if applicable). 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. Wholesale Licensees that have a change of name, change of owners, change of category, or change of address must call our office at 614-466-4143 for the correct applications, instructions, and background check forms (if applicable). 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 April 14, 2012