Forms

Application form to request a replacement wall certificate.

Use this form to order a large format wall certificate (17.5 inches x 23 inches).

Application checklist for a community pharmacy Certificate of Accreditation.

The owner/designated manager must provide notice to the College of the provision, or utilization of central fill services within 7 days upon entering into or revising an agreement.

Complete this form to add or remove compounding supervisors in your community pharmacy.

Checklist for opening a Remote Dispensing Location Dispensary staffed by a pharmacy technician.

Checklist for opening a Remote Dispensing Location with an Automated Pharmacy System.

This form must be filed within 30 days of a community pharmacy closing.

Operators who wish to temporarily close an accredited pharmacy for a period exceeding 3 days must complete this form.

The College must be notified within 30 days of a corporate amendment coming into effect by filing this form.

The College must be notified and approve of any material change to the size or physical layout of an existing accredited pharmacy.

The owner/designated manager of a community pharmacy must inform the College within seven days of starting to dispense methadone for methadone maintenance treatment.

To be used by employers, facility operators and health professionals to report a concern under the Regulated Heath Professions Act.

Registrant are required to self-report to the College under certain circumstances.

Third-party consent form authorizes a designated individual or entity to act on your behalf for the purposes of an official complaint.

Credit card authorization form for pharmacy fees.

Credit card authorization form for registrant fees.

How to change the Designated Manager of a community pharmacy.

Designated Manager Certificate.

Dreg Preparation Premises are to use this form to change the designated member on file with the College.

Complete this form to add or remove compounding supervisors, and to identify the compounding method they supervise.

If you have received notice of an upcoming assessment, complete this document and have it ready to share with your DPP advisor when they visit.

This form must be filed within 30 days of a Drug Preparation Premises closing.

Registrants who engage in or supervise drug preparation activities must complete this form.

Complete this form to renew a Certificate of Authorization for a Professional Corporation.

Application for Certificate of Authorization for a Health Profession Corporation.

Statement of delivery form.

Pre-hearing conference memorandum form.

Notice of motion form.

Draft order form.

Request for hearing adjournment

Summons to witness for hearings held by videoconference.

Summons to a witness before the Discipline Committee.

Request for a discipline hearing to be conducted in writing or electronically.

Expert witnesses use this form to acknowledge their duties.

This declaration of good character is required of Directors of the Corporation.

Hospital pharmacies use this form to apply for Certificate of Accreditation.

Complete this form to add or remove compounding supervisors in your hospital pharmacy.

This form is used by accredited hospital pharmacies wishing to change the Manager and/or Designated Contact on file with the College.

Renewal form for hospital pharmacy accreditation.

This form must be filed within 30 days of a hospital pharmacy closing.

Patients use this form to request funding for therapy or counselling under the Patient Relations Program.

A patient's therapist or counsellor uses this form to request funding under the Patient Relations Program.

Patients to complete this therapist or counsellor information form as part of the patient relations program.

Patients to complete this form for reimbursement for past therapy or counselling as part of the patient relations program.

PACE learning action plan for pharmacist applicants.

Practice Assessment of Competence at Entry (PACE) assessors use this form to agree to their responsibilities as a PACE assessor.

Pharmacists who are interested in applying to become a Practice Assessment of Competence at Entry (PACE) assessor for pharmacists use this form.

Education action plan.

Learning activity worksheet.

For Part B registrants to notify the College that they preparing to move to Part A.

Application for reinstatement of Certificate of Registration.

A pharmacist or pharmacy technician who asks to renew their Part A Certificate of Registration must provide a declaration of competence to provide patient care.

Each applicant must complete a declaration of good character when applying for a Certificate of Registration.

Complete this form to report your non-accredited workplace that is not already listed in our database.

Complete this form to declare you have personal professional liability insurance.

Emergency Assignment Certificate of Registration holders use this form to report injection training, CPR and first aid certification.

Emergency Assignment Certificate of Registration holders use this form to report workplace information and supervision.