Applications and Forms

Applications are valid for one year.

Pharmacists

Download this pdf file. Affidavit Regarding Citizenship Pharmacy

Download this pdf file. Application For Certification of DTMP  

Download this pdf file. Nuclear Pharmacist Application  

Download this pdf file. Pharmacist Application for Inactive Status  

Download this pdf file. Pharmacist Application  

Download this pdf file. Pharmacist Online Application Supplement Packet  

Download this pdf file. Qualified Alien Status Form GBP  

Download this pdf file. Reciprocity Information and Supplement Packet  

Download this pdf file. Reinstatement - Reactivation Application  

 

Pharmacy Interns

Download this pdf file. Pharmacy Intern Application  

Download this pdf file. Pharmacy Intern Online Application Supplement Packet  

Download this pdf file. Pharmacy Internship Report  

Download this pdf file. Qualified Alien Status Form GBP  

 

Pharmacy Technicians

Download this pdf file. Affidavit Regarding Citizenship Pharmacy

Download this pdf file. Pharmacy Tech Online Application Supplement Packet

Download this pdf file. Pharmacy Technician Additional Employment Form  

Download this pdf file. Pharmacy Technician Change of Employment Notification Form  

Download this pdf file. Qualified Alien Status Form GBP  

 

Pharmacy Facilities

Download this pdf file. Affiliate Annual Disclosure Statement Form  

Download this pdf file. Durable Medical Equipment Suppliers Facility Application

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

Download this pdf file. Non-Resident Pharmacy Facility Application  

Download this pdf file. Non-Resident Pharmacy PIC Change Form  

Download this pdf file. Notice Form for Authorized Collection

Download this pdf file. Pharmacy Facility Application  

Download this pdf file. Pharmacy Facility Pharm Tech Disassociation Form  

Download this pdf file. PIC Change Request Form  

 

Pharmacy Education & CE Programs

Download this pdf file. Application for Pharmacy School License

Download this pdf file. CE Program Application & Approval Form

 

Board Services, Requests, or Petitions

Download this pdf file. Duplicate Pharmacy License - License Verification Order Form  

Download this pdf file. Petition for Pharmacy Variance or Waiver

Download this pdf file. Roster Request Form  

Download this pdf file. Wall Certificate Order Form  

 

Guidelines & Information

Download this pdf file. Fee Schedule  

Download this pdf file. Instructions for GBOP Background Check

Download this pdf file. Reciprocity Information and Supplement Packet  

Download this pdf file. Secure and Verifiable Documents Under O.C.G.A. 50-36-2

 

Board Order Compliance Forms

Download this pdf file. Quarterly Reporting Form - Employer  

Download this pdf file. Quarterly Reporting Form - Personal  

Download this pdf file. Quarterly Reporting Form - Treatment