Form - FORMS (18VAC110-21)

Current through Register Vol. 40, No. 22, June 17, 2024

Form - FORMS (18VAC110-21)

Application for Licensure as a Pharmacist by Examination (rev. 3/2023)

Application for Licensure as a Pharmacist by Endorsement (rev. 3/2023)

Instructions for Reinstating or Reactivating a Pharmacist License (rev. 3/2023)

Instructions for Reinstating a Pharmacy Technician Registration (rev. 4/2023)

Application for Registration as a Pharmacy Technician (eff. 6/2021)

Application for Registration as a Limited-Use Pharmacy Technician for use exclusively in a free clinic (rev. 3/2023)

Affidavit for Limited-use Pharmacy Technician (rev. 5/2018)

Application for Approval of Pharmacy Technician Training Program (rev. 10/2020)

Application for Registration as a Pharmacy Technician Trainee (rev. 8/2023)

Application for Registration as a Pharmacy Intern (rev. 3/2023)

Application for Registration as a Pharmacy Intern for Graduates of a Foreign College of Pharmacy (rev. 3/2023)

Affidavit of Practical Experience as a Pharmacy Intern (rev. 3/2019)

Name Change Form for Individuals (rev. 3/2018)

Application for Approval of a Continuing Education Program (rev. 10/2020)

Application for Approval of an Innovative (PILOT) Program (rev. 6/2021)

Application for Approval of a Repackaging Training Program (rev. 10/2020)

Continuing Education (CE) Credit Form for Preceptors (rev. 7/2020)

Application for Approval of ACPE Accredited Pharmacy School Course(s) for Continuing Education Credit (rev. 6/2020)

Sponsor Certification for Volunteer Registration (rev. 4/2018)

Application for Volunteer Practice by a Pharmacist (rev. 4/2018)

Continuing Education (CE) Credit Form for Volunteer Practice (rev. 4/2018)

Derived From Virginia Register Volume 36, Issue 06, eff. 12/11/2019; Amended, Virginia Register Volume 39, Issue 21, eff. 7/5/2023; Amended, Virginia Register Volume 40, Issue 3, eff. 10/25/2023.

Statutory Authority: §§ 54.1-2400 and 54.1-3307 of the Code of Virginia.