| RENEWAL STATEMENTS |
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Pharmacy Statement
(PRINT, COMPLETE AND MAIL) |
|
Pharmacist Statement
(PRINT, COMPLETE AND MAIL) |
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Retail Oxygen Statement
(PRINT, COMPLETE AND MAIL) |
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Manufacturing Statement
(PRINT, COMPLETE AND MAIL) |
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Non-Resident Statement
(PRINT, COMPLETE AND MAIL) |
| DEA |
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SAMPLE Alabama Scheduled Listed Chemical Products Logbook
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DEA Form 106 - Report of Lost or Stolen Controlled Substances
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Pharmacists Manual
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SAMPLE Employee Self-Certification Training Form
(Training Required by September 30, 2006)
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DEA Training Materials for Retailers
|
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DEA Training Materials for Mobile Retailers
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ARTICLE 9. PRECURSOR CHEMICALS ยง20-1-190. - Sale of Pseudoephedrine
Attn: Wholesalers
|
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DEA TIP LINE - 24-hour, toll free "pill mill" tip line is: 888-954-4662 OR Email to:
Florida.Pill.Mill.Tips@USDOJ.GOV
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PHARMACY BURGLARY PROCEDURES
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| NUCLEAR PHARMACY AND NUCLEAR PHARMACY AND PHARMACIST CERTIFICATE APPLICATION
|
|
NUCLEAR PHARMACY AND PHARMACIST CERTIFICATE APPLICATION
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| PHARMACIST, INTERN/EXTERN, PRECEPTOR, TECHNICIAN
|
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Duplicate License/Registration Request
|
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Change of Supervising Pharmacist
|
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Change of Name Notification
NOTE: NO FEE FOR CHANGE OF NAME FOR AN INTERN/EXTERN.
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| PHARMACISTS |
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E-mail lmartin@albop to Reinstate a Pharmacist License
|
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Score Transfer College Affidavit
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Intern / Extern Application
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Practical Training / Internship Report
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Preceptor Application
|
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Consultant Application
(FAX
TO 205-981-2330 OR MAIL) |
|
Pharmacy Internship Training Agreement (TO BE COMPLETED BY NON-LICENSED PHARMACIES)
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| 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
|
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Non-Pharmacist Key Holder Designation Form
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Duplicate License/Registration Request
|
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Permit Change of Status Report - Hours of Operation
|
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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 notification print
BLANK MWD Renewal Application
|
| 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.
|
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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.
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BLANK - PHARMACY REGISTRATION RENEWAL 2017-2018
FOR IN-STATE PHARMACIES ONLY!
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New Pharmacy Services Permit
|
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Precursor Chemical Application
If requesting a change of address, name change or ownership notification print
|
|
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 |
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Inventory of Controlled Substances Book
|
|
SAMPLE Alabama Scheduled Listed Chemical Products Logbook
|
| PRESCRIPTIVE AUTHORITY |
|
H1N1 - What You Need to Know
(Flu Shot)
(Nasal Spray)
|