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The Board of Pharmacy will NOT contact you by telephone and demand payment of funds for any reason. Please be aware of scammers identifying as board staff and using phone numbers issued to the board.

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Forms - Pharmacy Interns

Pharmacy Interns

 

Application for New Pharmacy Intern Registration

The Application for New Pharmacy Intern Registration is available by electronic format (online). To preview the application and review the application checklist visit the Application Process Transparency page.  If you require a paper application, you may submit a written request to the Board office for that document. 

To start your application, click here.

033 ~ Professional Credentials Disclosure Form

021 ~ Pharmacist's Certification of Hours of Professional Experience Earned by Pharmacy Interns WITHIN Louisiana

022 ~ Pharmacist's Certification of Hours of Professional Experience Earned by Pharmacy Interns OUTSIDE Louisiana

070 ~ Pharmacist's Certification of Hours of Professional Experience Earned with Special Work Permit 

 

Retired Forms 

The following forms have been retired and are no longer available. Please log into your online services account and select the appropriate link to complete these tasks.

091 ~ Notice of Name Change

092 ~ Notice of Pharmacy Employment