Get Ia Pharmacist-intern Registration Application 2019-2026

Completing the IA Pharmacist-Intern Registration Application online is a crucial step for aspiring pharmacy interns in Iowa. This guide will provide you with clear and detailed instructions on how to successfully fill out each section of the application, ensuring that you meet all necessary requirements.

Follow the steps to complete your application with ease.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editing tool.
2. Begin with the registrant information section. Fill in your full legal name, date of birth, gender, and Social Security number accurately.
3. List any previous names you have used, if applicable. Ensure that your primary address is complete with street address, city, county, state, and zip code.
4. Provide your email address and telephone number, indicating whether it is your home or mobile number. If your mobile number is listed, confirm whether you accept text messages.
5. If your college address differs from your primary address, complete that section with the name of the college, your current status as a student, and your anticipated graduation date.
6. Complete the internship section by indicating your pharmacy name and license number if you have a preceptor. If not, you may leave it blank and notify the Board once assigned.
7. If you are currently employed in a pharmacy, fill out the current employment section with relevant details.
8. In the license/registration information section, list any states where you have held professional licenses or registrations as required.
9. Address any criminal history and disciplinary history questions truthfully. If you answer 'yes,' prepare a signed explanation and attach court records.
10. In the medical condition section, answer questions regarding any conditions or substance usage that may impact your internship duties. Provide explanations on a separate sheet if necessary.
11. Review your entire application for accuracy and completeness. Sign and date the application in the required section.
12. Finally, submit the completed application along with the required fee to the prescribed address of the Iowa Board of Pharmacy.

Take the next step in your pharmacy career by completing your application online today!