Applications and Forms

Applications are valid for one year.

Pharmacists

Affidavit Regarding Citizenship Pharmacy

Application For Certification of DTMP 

Nuclear Pharmacist Application 

Pharmacist Application for Inactive Status 

Pharmacist Application 

Pharmacist Online Application Supplement Packet 

Qualified Alien Status Form GBP 

Reciprocity Information and Supplement Packet 

Reinstatement - Reactivation Application 

 

Pharmacy Interns

Pharmacy Intern Application 

Download this pdf file. Pharmacy Intern Online Application Supplement Packet  

Pharmacy Internship Report 

Qualified Alien Status Form GBP 

 

Pharmacy Technicians

Affidavit Regarding Citizenship Pharmacy

Pharmacy Tech Online Application Supplement Packet

Pharmacy Technician Additional Employment Form 

Pharmacy Technician Change of Employment Notification Form 

Qualified Alien Status Form GBP 

 

Pharmacy Facilities

Download this pdf file. Affiliate Annual Disclosure Statement Form  

Durable Medical Equipment Suppliers Facility Application

Download this pdf file. Low-THC Pharmacy Dispensary Specialty Permit

Non-Resident Pharmacy Facility Application 

Non-Resident Pharmacy PIC Change Form 

Notice Form for Authorized Collection

Download this pdf file. Pharmacy Facility Application  

Pharmacy Facility Pharm Tech Disassociation Form 

PIC Change Request Form 

 

Pharmacy Education & CE Programs

Application for Pharmacy School License

CE Program Application & Approval Form

 

Board Services, Requests, or Petitions

Duplicate Pharmacy License - License Verification Order Form 

Petition for Pharmacy Variance or Waiver

Roster Request Form 

Wall Certificate Order Form 

 

Guidelines & Information

Download this pdf file. Fee Schedule  

Instructions for GBOP Background Check

Reciprocity Information and Supplement Packet 

Secure and Verifiable Documents Under O.C.G.A. 50-36-2

 

Board Order Compliance Forms

Quarterly Reporting Form - Employer 

Quarterly Reporting Form - Personal 

Quarterly Reporting Form - Treatment