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  • FORMS & APPLICATIONS - Alabama Board Of Pharmacy(current)

FORMS & APPLICATIONS

PHARMACISTS

  • New Application
  • Duplicate License/Registration Request
  • College Affidavit
  • Change of Supervising Pharmacist
  • E-mail rtindle@albop.com to reinstate a pharmacist’s license
  • Change Your Contact Info & Employment
  • Preceptor Certification Application
  • Nuclear Pharmacy and Pharmacist Certification Application
  • Consultant Certification Application
  • Parenteral Certification Application

INTERNS

  • Interns New Application
  • Proof of enrollment form
  • Duplicate License/Registration Request
  • Change your address or employment

PHARMACY TECHNICIANS

  • New Application
  • Duplicate Registration Request Form
  • Board Approved Technician Training Programs
  • Technician Training Verification Form
  • Instructions on how to upload technician training is here
  • Reinstatement Application
  • Continuing Education
  • To Change Your Address or Employment Click Here
  • When Technician Training form is complete click here
  • New Technician Training Rule

IN-STATE PHARMACIES

  • In-State Pharmacies New Application
  • In-State Reinstatement/Change or Ownership Pharmacy Application
  • New Institutional Pharmacy Application
  • Institutional Reinstatement/Change of Ownership Application
  • Change of Supervising Pharmacist (Both Incoming and Outgoing Pharmacist must complete)
  • Closing A Pharmacy in Alabama
  • Non-Pharmacist Key Holder Designation Form
  • Revocation of Non-Pharmacist Key Holder Form
  • Controlled Substance Waiver
  • Change of Operations Form
  • New Pharmacy Application – Check List
  • Pharmacy Change of Name or Address Form
  • Burglary Procedures

FACILITIES

  • See Alabama Administrative code 680-X-2-.23 Section 1 for Facility Definitions
  • New Manufacturer Application
  • New Private Label Distributor Application
  • New Repackager Application
  • New 503B Application
  • Facility Change of Ownership Form
  • Change of Designated Representative Form
  • Update CURRENT Designated Representative Information Form
  • Business History Affidavit
  • Controlled Substance Waiver
  • For reinstatement, E-mail sgamble@albop.com
  • Individual History Affidavit
  • Application Contact Form
  • Duplicate License Request Form

CONSUMER SERVICES

  • Complaint Form
  • Copy of in-state inspections E-mail pwright@albop.com

NON-RESIDENT PHARMACIES

  • New Non-resident Pharmacy Application
  • 795 Non-Sterile Compounding Questionnaire (Must also submit VPP Inspection)
  • Reinstatement/Change of Ownership Form
  • Controlled Substance Waiver
  • Checklist For Closing a Non-Resident Pharmacy
  • 797 Sterile Compounding Questionnaire (Must also submit VPP Inspection)
  • Change of Name or Address Form
  • Duplicate License/Registration Request
  • Change of Supervising Pharmacist (Both Incoming and Outgoing Pharmacist must complete)
  • Change of Operations Form

PHARMACY SERVICES

  • New In-state Pharmacy Services Application (Must appear before the Board before license can be granted)
  • New Non-resident Pharmacy Services Application
  • Reinstatement/Change of Ownership Application
  • Duplicate License/Registration Request
  • DEA Form 106 – Report of Lost or Stolen Controlled Substances
  • Change of Name or Address Form
  • Change of Supervising Pharmacist (Both Incoming and Outgoing Pharmacist must complete)

PRECURSOR

  • New Precursor Application
  • For reinstatement, E-mail sgamble@albop.com
  • Duplicate License Request Form

OXYGEN

  • New Retail Medical Oxygen Application (email to tking@albop.com)
  • New Oxygen Manufacturer/Wholesaler Application
  • Retail Medical Oxygen Reinstatement/Change of Ownership, Name or Address Application email to tking@albop.com
  • Duplicate License Request Form

DEA

  • SAMPLE Alabama Scheduled Listed Chemical Products Logbook
  • PHARMACY BURGLARY PROCEDURES
  • SAMPLE Employee Self-Certification Training Form (Training Required by September 30, 2006)

Contact Us

Contact Us
  • If none of these departments apply to your question, please visit our Board Office Directory to find the appropriate email.
Visit us 111 Village Street Birmingham, AL 35242
Give Us A Call (205) 981-2280
Send us a message Click Here to Find the Right Contact Person
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