Applications/Forms
Publications
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Pharmacist Forms
A Pharmacist licensed in another state must reciprocate their license to South Carolina by first contacting the National Association of Boards of Pharmacy (NABP)at www.nabp.org. or 847-391-4406.
- Pharmacist Application by Examination
- Pharmacist Application by Score Transfer
- Change of Employment Notification
- Change of Address Notification
- Notification of Pharmacist-In-Charge Change
- Pharmacist Reinstatement of Lapsed License Form
- Pharmacist Instructions for Reinstatement of Inactive License
- Foreign Graduates Info web Site
- Important Updated Information about Pharmacist License Renewal
- Pre-license Agreement Form
- NAME AND/OR ADDRESS CHANGE REQUEST FORM
Pharmacy Technician Forms
- Pharmacy Technician Renewal Form 2012-2013
- Pharmacy Technician Reinstatement
- Pharmacy Technicians who have not renewed their registration for two years or more will be required to complete this application.
- Pharmacy Technician Registration Application
- Approved Pharmacy Technician Duties-Policy
- Change of Address Notification
- Change of Employment Notification
- NAME AND/OR ADDRESS CHANGE REQUEST FORM
Pharmacy Technician State Certification
- Pharmacy Technician State Certification Requirements
- Pharmacy Technician Affidavit of Experience
- Pharmacy Technician Certification of Clinical Experience
Pharmacy Intern Forms
- Pharmacy Intern Certificate Application
- Affidavit of Practical Experience
- Notification of Employment
- Certification of Clinical Experience
- NAME AND/OR ADDRESS CHANGE REQUEST FORM
Facilities Permits and Registration Required Forms
- New Pharmacy Permit Application
- Pharmacy Permit is required for any outlet located in South Carolina that dispenses drugs requiring a prescription or order from a practitioner licensed to prescribe drugs. A permit holder and a pharmacist-in-charge must be designated on every pharmacy permit application.
- New permits are required for any Change of Ownership, Change of Pharmacy Name, or Change of Location from one city to another. Permits are not transferable and each location requires its own permit. Correctly completed applications for new permits or changes to existing permits must be received in the Board of Pharmacy office at least 45 days before the opening date of the facility or effective date of a change. An on-site inspection is required before a permit will be issued.
- Permit Holders that are relocating their facility within the same city are required to submit a Relocation Application to the Board of Pharmacy office at least 45 days before the relocation occurs.
- For additional information concerning the State Controlled Substances Registration, please contact Diana Granger at (803) 896-0636.
- Non-Dispensing Drug Outlet Permit Application
- Non-Dispensing Drug Outlet Permit is required for any outlet located in South Carolina that administers and/or stores legend drugs. Facilities requiring a Non-Dispensing Drug Outlet Permit include, but are not limited to, clinics, wholesalers, manufacturers, and distributors. A Non-Dispensing Drug Outlet Permit requires a consultant pharmacist, unless the facility is engaged in manufacturing, wholesaling, or distributing.
- If the outlet possesses, dispenses or stores controlled substances in South Carolina, a South Carolina Controlled Substances Registration from the South Carolina Department of Health and Environmental Control, Division of Drug Control and a Federal DEA Registration must be obtained prior to engaging in such activity. Neither the State Controlled Substances Registration nor the Federal DEA Registration will be issued until after the State Pharmacy or Drug Outlet Permit has been issued; however, you may submit all of the applications to the respective agencies at the same time, indicating that the State permit number is pending.
- Medical Gases/Legend Device Permit Application
- A Medical Gases/Legend Devices Permit allows a facility to dispense to a patient or to a patient's agent medical gases and legend devices on the order of a licensed practitioner. A Medical Gases/Legend Devices Permit allows a Medical Director, Respiratory Therapist, Registered Nurse, or Consultant Pharmacist to be responsible and accountable for duties of the Consultant Pharmacist as provided in section 40-43-86 (C).
- Non-Resident Pharmacy Permit Application
- A Non-Resident Pharmacy Permit authorizes facilities outside of this State whose primary business is filling mail order or internet prescriptions to engage in the sale, distribution, or dispensing of legend drugs or devices in this State.
- Non Resident Wholesale Distributor and/or Manufacturer Application
- A Non-Resident Wholesale Distributor Permit is required for all wholesalers, distributors and brokers that wish to do business in this state.
- Non-Resident Medical Gas & Legend Device Permit Application
- This permit authorizes a facility to dispense to a patient or patient’s agent, medical gases and legend devices on the order of a licensed practitioner.
- FQHC Drug Outlet Permit
- This permit authorizes a Federally Qualified Health Center delivery site to store, administer and distribute patient-specific, labeled medications received from a permitted FQHC pharmacy or contracted pharmacy.
- New EMS Non-Dispensing Drug Outlet Permit Application
- Relocation (within the same city)
- Non-Resident Relocation (with in the same city)
Notification Forms:
- Notification of Consultant Pharmacist Change
- Notification of Permit Holder Change
- Notification of Pharmacist-In-Charge Change
Inspection Report Forms
- Institutional Pharmacy
- Medical Gases Legend Devices Drug Outlet
- Non-Sterile Compounding Pharmacy
- FQHC Non-Dispensing Drug Outlet
- Nuclear Pharmacy
- Non-Dispensing Drug Outlet Permit
- Detention Center Non-Dispensing Drug Outlet
- EMS Self-Inspection Report
- Retail Pharmacy Report 2
- Sterile Permit Inspection Checklist
- Wholesale Distributor Drug Outlet


