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Forms, Applications and Instructions for Pharmacies



IMPORTANT NOTICE REGARDING PHARMACY & DME PERMIT MEETINGS: Permit meetings begin promptly at 10:00 am on the first Monday and the Monday prior to the third Tuesday of each month (unless otherwise noted - see calendar). Check-in time for the meeting is at 9:45 am. Late arrivals will not be allowed into the permit meeting. Accordingly, if you cannot arrive at the Board office before 10:00 am on the meeting date, your permit application will not be considered, and you will have to attend a future permit meeting.

Click here for instructions on how to print a duplicate pharmacy certificate.

Click here for PHARMACIST-MANAGER information/instructions.




Procedures/Instructions for Submitting Pharmacy Permit Applications (includes checklist) - PLEASE READ PRIOR TO COMPLETING AN APPLICATION.

2016 Application for Registration and Permit to Conduct a Pharmacy Inside North Carolina

2016 Application for Registration and Permit to Conduct a Pharmacy Outside North Carolina

Pharmacy Services Affidavit

Pharmacy Services Data Questionnaire (To be completed when there is a change in the services your pharmacy provides)

Credit Card Authorization Form

Non-Controlling Officer/Owner Change Form

Transfer of ownership information/instructions

Address change information/instructions

Percentage of ownership change within an existing group of stakeholders - information/instructions

Inspection Forms (includes Hospital, Retail, Compounding)

Form for Closing a Pharmacy

Pharmacist-Manager Change Instructions

Pharmacy Name Change Form

Out-of-State Pharmacist/Pharmacy Certification Form

Pharmacist-Manager Responsibilities

Request for Increase in Pharmacist-to-Technician Ratio

Drug Disaster & Loss Report

Drug Disposal Form & Procedures

Incident Report

Pharmacy Security Check List - developed by the National Association of Drug Diversion Investigators (NADDI)

Controlled Substances Inventory Log



For questions about pharmacy permits, please contact Wendy Watson at 919.246.1050 ext. 221 or by email at