Board of Pharmacy
Applications and Forms
► Applying for initial licensure from your professional licensing board has become a bit easier. For the past year, the Department of Health has been working on an online application process that will allow all health care professionals to apply online for an initial license and complete (and update as necessary) a practitioner profile mandatory for certain professions. The process is user-friendly and convenient and even allows you to pay for your initial application utilizing a credit card, debit card, or e-check. You will also be able to upload many of the documents required to complete your initial application! Please go to the initial application link below to begin the online process.
- Pharmacy Tech Ratio Wavier Request Form
- Information concerning reporting for Compounding Facilities
- 2015 Law Books (limited supply)
- Criminal Background Checks
- Expedited Licensure for Military Members
- Declaration of Eligibility Licensure Process - Spouse of Military Member
- Application for Duplicate License | (paper application-4302)
- Affidavit of Retirement From Practice in Tennessee (paper application-3460)
- Medical Service Representative Application | (paper application-4019)
- Name and Address Change Form | (paper application-3619)
Pharmacist
► Applying for initial licensure from your professional licensing board has become a bit easier. For the past year, the Department of Health has been working on an online application process that will allow all health care professionals to apply online for an initial license and complete (and update as necessary) a practitioner profile mandatory for certain professions. The process is user-friendly and convenient and even allows you to pay for your initial application utilizing a credit card, debit card, or e-check. You will also be able to upload many of the documents required to complete your initial application! Please go to the initial application link below to begin the online process.
- New Graduates
- Declaration of Citizenship (paper application-4183)
- Instructions for obtaining a Reciprocal License
- Application for Pharmacist Examination
- Instructions for Applying to the NAPLEX/MPJE Examination
- Internship Affidavit (paper application-4027)
- Request for Testing Accommodations
- Mandatory Practitioner Profile Questionnaire (paper application-3585)
- Instructions on how to Reinstate a Pharmacist License (paper application-4303)
- Instructions to obtain a Foreign Graduate License
- College Certification Form
Facility License Information
► Applying for initial licensure from your professional licensing board has become a bit easier. For the past year, the Department of Health has been working on an online application process that will allow all health care professionals to apply online for an initial license and complete (and update as necessary) a practitioner profile mandatory for certain professions. The process is user-friendly and convenient and even allows you to pay for your initial application utilizing a credit card, debit card, or e-check. You will also be able to upload many of the documents required to complete your initial application! Please go to the initial application link below to begin the online process.
- Pharmacy Application Form
- Name, Location or Ownsership Change Application for Pharmacy Business
- Name, Location, or Ownership Change Automated Dispensing Machine Application Form
- Automated Dispensing Machine Application Form
- Pharmacy Survey
- Pharmacist In Charge Statement Form (paper application-4012)
- Gap Analysis-Board of Pharmacy
- Bedside Delivery Attestation (paper application-4201)
- Pharmacy Transfer & Closing Instructions
Manufacturer/Wholesale/Distributor
- Third-Party Logistics Provider Survey
- Change in Facility Manager (paper application-4229)
- Tennessee State Rules for Manufacturer/Wholesale/Distributor
- Manufacturer Application
- Name, Location or Ownership Change Application for Manufacturer
- Wholesaler/Distributor Application
- Name, Location or Ownership Change Application for Wholesaler/Distributor
- Outsourcing Facility Application
- Name, Location or Ownership Change Application for Outsourcing Facility
- Oxygen Supplier Application
- Name, Location or Ownership Change Application for Oxygen Supplier
- Manufacturer Survey
- Outsourcing Facility Survey
- Oxygen Supplier Survey
- Wholesale/Distributor Survey
- Third-Party Logistic (3PL) Application
Pharmacy Technician
► Applying for initial licensure from your professional licensing board has become a bit easier. For the past year, the Department of Health has been working on an online application process that will allow all health care professionals to apply online for an initial license and complete (and update as necessary) a practitioner profile mandatory for certain professions. The process is user-friendly and convenient and even allows you to pay for your initial application utilizing a credit card, debit card, or e-check. You will also be able to upload many of the documents required to complete your initial application! Please go to the initial application link below to begin the online process.
- Declaration of Citizenship (paper application-4183)
- Pharmacy Technician Application for Registration
- Request to Reapply for Registration as a Pharmacy Technician
- Pharmacy Technician Affidavit (paper application-4013)
Researcher
► Applying for initial licensure from your professional licensing board has become a bit easier. For the past year, the Department of Health has been working on an online application process that will allow all health care professionals to apply online for an initial license and complete (and update as necessary) a practitioner profile mandatory for certain professions. The process is user-friendly and convenient and even allows you to pay for your initial application utilizing a credit card, debit card, or e-check. You will also be able to upload many of the documents required to complete your initial application! Please go to the initial application link below to begin the online process.
- Application for Researchers
- Application for Training of Detection Animals
- Location Change/Reinstatement Application for Researchers
- Location Change/Reinstatement Application for Training of Detection Animals