Alabama Board of Pharmacy

Forms, Apps and Publications

CONSULTANT

CONTROLLED SUBSTANCE WAIVER

DEA

LIST OF ACCEPTABLE DOCUMENTS

NUCLEAR PHARMACY AND
PHARMACIST CERTIFICATE APPLICATION

PHARMACIST, INTERN/EXTERN, PRECEPTOR,
TECHNICIAN

DO NOT MAIL CASH!

MANUFACTURER/WHOLESALE/DISTRIBUTION,
PHARMACY, INSTITUTION, ETC.

PHARMACY LOG BOOKS

PRESCRIPTIVE AUTHORITY

RETAIL MEDICAL OXYGEN

UPDATE OR ADD EMAIL ADDRESS

The Pharmaceutical Providers Tax Pamphlet - Alabama Department of Revenue

RENEWAL STATEMENTS
Pharmacy Statement   (PRINT, COMPLETE AND MAIL)
Pharmacist Statement   (PRINT, COMPLETE AND MAIL)
Retail Oxygen Statement   (PRINT, COMPLETE AND MAIL)
Manufacturing Statement   (PRINT, COMPLETE AND MAIL)
Non-Resident Statement   (PRINT, COMPLETE AND MAIL)


DEA
SAMPLE  Alabama Scheduled Listed Chemical Products Logbook  
DEA Form 106 - Report of Lost or Stolen Controlled Substances  
Pharmacists Manual  
SAMPLE  Employee Self-Certification Training Form    (Training Required by September 30, 2006)
DEA Training Materials for Retailers  
DEA Training Materials for Mobile Retailers  
ARTICLE 9. PRECURSOR CHEMICALS §20-1-190. - Sale of Pseudoephedrine    Attn: Wholesalers
DEA TIP LINE - 24-hour, toll free "pill mill" tip line is: 888-954-4662 OR Email to: Florida.Pill.Mill.Tips@USDOJ.GOV  
PHARMACY BURGLARY PROCEDURES  

NUCLEAR PHARMACY AND NUCLEAR PHARMACY AND PHARMACIST CERTIFICATE APPLICATION
NUCLEAR PHARMACY AND PHARMACIST CERTIFICATE APPLICATION  

PHARMACIST, INTERN/EXTERN, PRECEPTOR, TECHNICIAN
Duplicate License/Registration Request  
Change of Supervising Pharmacist  
Change of Name Notification   NOTE: NO FEE FOR CHANGE OF NAME FOR AN INTERN/EXTERN.
PHARMACISTS
E-mail lmartin@albop to Reinstate a Pharmacist License
Score Transfer College Affidavit  
Intern / Extern Application  
Practical Training / Internship Report  
Preceptor Application  
Consultant Application   (FAX TO 205-981-2330 OR MAIL)
Pharmacy Internship Training Agreement (TO BE COMPLETED BY NON-LICENSED PHARMACIES)  
TECHNICIANS
ONLINE- 2016/17 NEW TECHNICIAN REGISTRATION    USER MANUAL  

*** MUST HAVE A RECENT PHOTO TO UPLOAD ****


MANUFACTURER/WHOLESALE/DISTRIBUTION, PHARMACY, INSTITUTION, ETC.
Closing A Pharmacy in Alabama  
Non-Pharmacist Key Holder Designation Form  
Duplicate License/Registration Request  
Permit Change of Status Report - Hours of Operation  
Change of Ownership Form  
MANUFACTURERS, WHOLESALERS, DISTRIBUTORS
NEW Manufacturers, Wholesalers, Distribution Registration   Must be printed on legal size paper.

Please also complete a Manufacturers, Wholesalers, Distribution Verification Form 

  If requesting a change of address, name change or ownership e-mail: kpickett@albop.com
NON-RESIDENT PHARMACIES
NEW Non-Resident Pharmacy Registration Application    Please also complete a Non-Resident Pharmacy Verification Form

If requesting a change of address, name change or ownership notification print

BLANK Non-Resident Renewal Application  
Inspection Report for 797 Sterile Compounding  

Non-Resident Pharmacies that compound Sterile products will need to complete and file this report along with their application.

Inspection Report for 795 Non-Sterile Compounding  

Non-Resident Pharmacies that compound Non-Sterile products will need to complete and file this report along with their application.

ALABAMA PHARMACIES AND OTHER (PHARMACY SERVICES, PRECURSORS, INSTITUTIONAL)
Pharmacy Registration Application (In-State Only)     Must be printed on legal size paper.
BLANK - PHARMACY REGISTRATION RENEWAL 2017-2018     FOR IN-STATE PHARMACIES ONLY!
New Pharmacy Services Permit 
Precursor Chemical Application    If requesting a change of address, name change or ownership e-mail: kpickett@albop.com  
Institutional Pharmacy Application   Must be printed on legal size paper.

If requesting a change of address, name change or ownership notification print


RETAIL MEDICAL OXYGEN
Retail Medical Oxygen Supplier Permit Application   Must be printed on legal size paper.

If requesting a change of address, name change or ownership notification print

BLANK Retail Medical Oxygen Supplier Renewal Application  

PHARMACY LOG BOOKS
Inventory of Controlled Substances Book  
SAMPLE Alabama Scheduled Listed Chemical Products Logbook  

PRESCRIPTIVE AUTHORITY
H1N1 - What You Need to Know  (Flu Shot)    (Nasal Spray)

-Adobe Acrobat Required.  NOTE: Some applications are legal size and require 8 1/2 x 14 paper when using Printable form.