PHARMACY TECHNICIAN APPLICATION INSTRUCTIONS
HOW LONG WILL IT TAKE?
- It takes the board 45 days to process your application.
- You will be notified by mail if your application is not complete.
- Please do not contact the board to check on your application unless it has been on file for over 60 days.
- If your check has cleared your bank,the board has received your application.
- To check if your license was issued, go to www.pharmacy.ca.gov. Select “Verify a License” and enter your name. It takes four to six weeks from the date a license is issued to receive the license in the mail.
WHAT MAKES AN APPLICATION COMPLETE?
Check the boxes below to be sure your application is complete before mailing it.
• If your application is not complete, you will receive a “Deficiency Notice” in the mail.
• You will then have 60 days to submit the required item(s)
• If you do not submit the required item(s) within 60 days, you may have to file a new application with new fees and meet any new requirements.
APPLICATION FEE $105: When you send your application, include a check or money order for $105 made payable to the Board of Pharmacy. This fee is not refundable.
APPLICATION FOR A PHARMACY TECHNICIAN LICENSE (form 17A-5 (rev. 01/11):Complete the entire application.
AVOID COMMON MISTAKES
• The name on each form must be EXACTLY THE SAME as the name on your state driver’s license or state – issued identification card. Your name must be the same on each of the following documents:
> Pharmacy Technician Application,
> Request for Live Scan form or fingerprint cards,and
> Self-Query Report.
• Have you ever used a different name? List each prior name on the application under Previous Names.
> Did you have a maiden name,married name,former name, AKA?
> Have you ever used Jr., Sr., II, etc., with your name?
> If you do not list all of your previous names, the board may not locate, match or verify your documents.
• Do not leave anything blank; use “N/A” if a question doesn’t apply to you.
• Do not let your school fill out Pages 1, 2 and 3 of your application.
• You must sign and date the application. No one else can sign it for you.
PHOTO: Attach a passport-style,glossy,color photo (2”x2”) taken within 60 days of mailing the application.DO NOT provide scanned images, Polaroids, or black-and-white photos.
BASIC EDUCATION: You must be a high school graduate or have a General Education Degree certificate equivalent.
Attach ONE of the following (A, B, C, or D):
A. U.S. High School Graduate: Attach an official, embossed transcript (academic record) or notarized copy of your high school transcript. It must have the graduation date on it. To get a copy of your high school transcript, contact your high school or its school district office.
B. Foreign High School Graduate : Attach a notarized copy of your foreign secondary school diploma or certificate OR a notarized copy of your foreign secondary school transcripts.
If not in English, then include a certified translation in English. The translation may be from an evaluation service that states your education is equal to graduating high school in the U.S.
C. General Educational Development (GED): Attach an official transcript of your test results or equivalent. GED test results are official only if they are earned through an authorized
GED Testing Center . To get your GED transcripts, go to http://www.gedtestingservice.com/testers/gedrequest-a-transcript. If your GED is from another state, you may need to request an official transcript of your GED test results from the agency in that state.
D. Certificate Equivalent – Attach an official “Certificate of Proficiency” showing you passed the California High School Proficiency Examination (CHSPE). To request a copy, go to
https://www.chspe.net/cert-trans/ or call (866) 342 – 4773.
PHARMACY TECHNICIAN DOCUMENTS:
Attach ONE of the following (A, B or C):
A. Affidavit of Completed Coursework or Graduation: The program director, school registrar or pharmacist must complete and sign the affidavit on Page 4. Copies or stamped signatures are not accepted. The school seal must be embossed on the affidavit and/or you must attach a pharmacist’s business card with license number. An affidavit is required for one of the following:
• Associate Degree in Pharmacy Technology;
• Any other course that provides a minimum of 240 hours of in struction as required;
• Training course accredited by the American Society of Health-System Pharmacists (ASHP);
• Graduation from a school of pharmacy accredited by the Accreditation Council for Pharmacy Education (ACPE).
B. Pharmacy Technician Certification Board (PTCB) certified : Submit a copy of your PTCB certificate.
C. Military Training : Submit a copy of your DD214 documenting evidence of your pharmacy technician training provided by a branch of the federal armed services.
SELF-QUERY REPORT:
Include a sealed,original Self-Query Report from the National Practitioner Data Bank (NPDB). It must be dated within 60 days of filing the application.
• Self-Query Reports that have been opened will not be accepted.
• The name on your Self-Query Report must be EXACTLY THE SAME as the name on your application.
• To request a Self-Query Report,go to http://www.npdb.hrsa.gov or call (800)767-6732 or TDD (703)802-9395. Their website has a fact sheet and answers to frequently asked
questions. The board is not able help you get the Self-Query Report. For help,contact NPDB directly.
• You must pay the fee directly to NPDB. The fee is $8.
Source from: California State Board of Pharmacy