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Licensure Forms and Checklists
Licensure Forms and Checklists
Pharmacy LIcensure Forms
- Form 1A: Application for New Pharmacy Licence – Community
- Form 1B: Application for New Telepharmacy Licence - Community
- Form 1C: Application for New Pharmacy Licence – Hospital
- Form 1E: Application for Hospital Satellite
- Form 1F: Application for New Pharmacy Licence – Pharmacy Education Site
- Form 4A: Application for Pharmacy Closure
- Form 4B: Application for Unanticipated Temporary Closure
- Form 4C: Closure for Suspended Pharmacy
- Form 5: Manager/Direct Owner/Indirect Owner – Proof of Eligibility
- Form 6: Manager/Direct Owner/Indirect Owner – Notice of Ineligibility
- Form 7: Indirect Owner – Email Contacts
- Form 8A: Application for Change of Direct Owner
- Form 8B: Application for Change of Indirect Owner(s)
- Form 8C: Application for Change of Manager
- Form 8D: Application for Change of Corporation Name
- Form 8E: Application for Change of Operating Name or External Signage Name
- Form 8F: Application for Change of Location
- Form 8G: Application for Change of Layout
- Form 9: Pharmacy Licensure - Multiple Pharmacies
- Form 10A: Pharmacy Pre-Opening Inspection Report – Community
- Form 10B: Pharmacy Pre-Opening Inspection Report - Community Telepharmacy
- Form 10C: Pharmacy Pre-Opening Inspection Report - Hospital
- Form 12: Payment Form - New Pharmacy Licence
- Form 13: Change of Authorized Representative
- Form 14: Extension Request for Application Committee
- Community Telepharmacy Inspection & Audit Form
Pharmacy Licensure Checklists
- Community Pharmacy/Telepharmacy Diagram Checklist
- Hospital Pharmacy/Hospital Pharmacy Satellite Diagram Checklist
- Ownership Requirements (Corporation as Direct Owner) Checklist