Pharmacist Licenses/Permits
- Change of Pharmacist in Charge
- Change of Pharmacist in Charge Extension Form
- License by Reciprocity
- License by Exam
- Pharmacist License Reinstatement Form
- Compounding Questionnaire
- Foreign Applicants
- Preceptor Application – For information about a preceptor license, please contact the Board at asbp@arkansas.gov or at 501‐682‐0190.
Interns
Pharmacy Technicians
- What’s the difference between Expedited and Standard Applications?
- Expedited 2024 Pharmacy Technician Application – In-State Applicants Only
- Standard 2024 Pharmacy Technician Application
- 2024 Pharmacy Technician Reinstatement
Criminal Background Check Forms
Effective July 28, 2021, in accordance with Act 630, background checks from individuals in Arkansas must be submitted electronically (live scan). Paper fingerprint cards will no longer be accepted and will be returned to the applicant and an electronic submission will be required before
the application on file with the Board can continue to be processed. Out-of-state applicants will still submit completed fingerprint cards, as the State of Arkansas is not currently set up to receive electronic fingerprint submissions from out-of-state locations.
- In-State Criminal Background Check Identity Verification (CBC) Form
- Out-of-State Criminal Background Check Identity Verification (CBC) Form
Business Licenses
- Retail Pharmacy Application – In State
- Retail Pharmacy Application – Out-of-State
- Hospital Pharmaceutical Services
- Wholesale Distributor of Legend Drugs
- Supplier of Medical Equipment, Legend Devices, and Medical Gas (DME license)
- Wholesale Distributor of List I Chemicals
- Charitable Clinic Application
- Pharmacist in Charge Compliance Affidavit
- Institutional Pharmaceutical Services: Please email a request with your name and address to asbp@arkansas.gov or call our office at 501-682-0190
Other Forms
BEGINNING JANUARY 1, 2018, THE ARKANSAS STATE BOARD OF PHARMACY WILL NO LONGER REVIEW AND APPROVE EDUCATION SESSIONS AS CONTINUING EDUCATION HOURS, THAT ARE NOT CO-SPONSORED/DEVELOPED BY THE ARKANSAS STATE BOARD OF PHARMACY. IF YOU HAVE QUESTIONS OR CONCERNS ABOUT THIS, CALL THE BOARD AT 501-682-0190.
- Change Form (Name, Address, or Employment)
- Facility Roster Change Form
- Closing of Pharmacy Form
- Online Complaint | Paper Complaint (email your complaint to asbp@arkansas.gov)
- Inspection Request Form
- Mailing List Order Form
- Wall Certificate Request Order Form
- Request for Waiver Form
- Medical Release Form
- Suggested Procedures When Buying or Selling a Pharmacy
- Overview of Prescribing Authority
- Purple Book | Orange Book
- Suspicious Order Report
- Samples of protocols, authority to administer immunizations, and sample forms for immunizations/vaccines
- Drug Categories for Emergency Kits in Long-Term Care Facilities
- Drug Categories for Emergency Kits in Crisis Stabilization Units
- Suggested Procedures When Buying or Selling a Pharmacy
- Effects of New Federal Meth Act on Arkansas Pseudo Law
- Multidose Memorandum of Understanding
- DBHS OBHS Regulation 4 Waiver
- Shrink Report Tool
- AR Pharmacy Support Group
