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How to fill out the Ph226 online
The Ph226 form, officially titled Notice of Resignation of Supervising Pharmacist, is a crucial document for notifying the New York State Board of Pharmacy of any changes in supervision. This guide provides a clear, step-by-step approach to completing the form online to ensure that all required information is accurately submitted.
Follow the steps to complete the Ph226 form online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering the registered name of the pharmacy in the space provided at the top of the form. Ensure that the name matches exactly as registered with the New York State Board of Pharmacy.
- Next, fill in the complete address of the pharmacy, ensuring to include the street address, city, state, and zip code.
- Enter the pharmacy registration number, which can be found on the registration certificate. Do not use the store number of a chain drug store in place of the registration number.
- Provide the establishment email address where correspondence can be directed regarding the resignation notification.
- In the next section, clearly write your full name as the resigning pharmacist, followed by your pharmacist license number.
- Indicate the date on which you resigned from the position of supervising pharmacist. Ensure to format the date in month/day/year style.
- Finally, sign the form at the bottom as the resigning pharmacist, and print your name below the signature.
- After completing all sections, review the form for accuracy. You may then save your changes, download the finished form, or print it out for submission.
- Submit the completed form to the New York State Board of Pharmacy either by emailing it to pharmbd@nysed.gov or by mailing it to 89 Washington Avenue, 2nd Floor West, Albany, NY 12234-1000.
Complete your Ph226 form online today to ensure timely notification of your resignation.
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