Get Ny Ph226 2017-2026

The NY PH226 form is essential for notifying the New York State Board of Pharmacy when a supervising pharmacist has resigned. This guide will help you navigate each section of the form to ensure it is completed accurately and submitted properly.

Follow the steps to complete the NY PH226 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Provide the registered name of the pharmacy in the designated field. Ensure that the name matches the registration documents to avoid any discrepancies.
3. Fill in the address of the pharmacy in the appropriate fields. This should include the street address, city, state, and zip code.
4. Locate and enter the pharmacy registration number. Do not confuse this with the store number of a chain drug store; only use the registration number listed on the certificate.
5. In the establishment email field, provide the email address associated with the pharmacy. This allows the Board of Pharmacy to contact the establishment if needed.
6. Next, enter your full name in the specified field to indicate the pharmacist who is resigning. Be sure it matches your official records.
7. Input your pharmacist license number. This number is crucial for identification purposes and ensures your application is processed correctly.
8. State the date of resignation in the format provided (month, day, year). This is important for record-keeping by the Board.
9. Sign the form by adding your signature in the designated area, confirming that the information provided is accurate.
10. Finally, review all entries for accuracy. Once confirmed, you can save changes, download, print, or share the completed form as needed.

Complete the NY PH226 form online to ensure a smooth notification process.