Arkansas State Board of Pharmacy

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Forms & Instructions

Many of the forms as well as other pieces of information offered on this site are provided in Adobe PDF format. If you do not have Adobe Reader, you can download it for FREE!

Pharmacist Licenses/Permits

Change of Pharmacist in Charge (PDF)
License by Examination (PDF)
License by Reciprocity (PDF)
Nursing Home Consultant (PDF)
Preceptor Application (PDF)
Foreign Applicants (PDF)
Administer Immunization Certification (PDF

Interns and Graduate Interns

Pharmacy Technicians

Pharmacy Technician Application (PDF)
Pharmacy Technician Reinstatement (PDF)

Business Licenses

Retail Pharmacy Application - In State (PDF)
Retail Pharmacy Application - Out of State (PDF)
Hospital Pharmaceutical Services (PDF)
Institutional Pharmaceutical Services (PDF
Wholesale Distributor of Legend Drugs (PDF)
Supplier of Medical Equipment, Legend Devices,
and Medical Gas (PDF)
Wholesale Distributor of List I Chemicals (PDF)
Charitable Clinic Application (PDF)

Other Forms

CE Approval Request Form PDF | Word
Change Form (PDF)
Closing of Pharmacy Form (PDF)
Complaint Form (PDF)
Inspection Request Form (PDF)
Order Form (PDF)
Request for Waiver Form (PDF)

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