Get Ca 17a-1a 2013-2025

Filling out the CA 17A-1A form is an important step for individuals seeking to retake the pharmacist licensure examination in California. This guide provides clear, step-by-step instructions on how to complete the form effectively and accurately.

Follow the steps to successfully complete your CA 17A-1A application.

1. Click the ‘Get Form’ button to obtain the CA 17A-1A form and open it in the editor.
2. Enter your full legal name in the designated field. Ensure it matches the name on all required identifications for consistency.
3. Provide your contact information, including mailing address and phone numbers. Ensure that all entries are current and accurate.
4. Indicate which examination you are applying to retake by checking the appropriate box: NAPLEX only, CPJE only for $260, or both exams for $260.
5. Submit your U.S. Social Security number or Individual Taxpayer Identification Number (ITIN) in the specified field.
6. Attach necessary identification documents as outlined, ensuring that they meet the requirements for testing site verification.
7. Complete the self-query report requirement by including a sealed report from the National Practitioner Data Bank (NPDB), dated within the last 60 days.
8. Sign and date the application to affirm the accuracy of your information. Remember that signing falsified information can result in denial of your application.
9. Review the completed form for any omissions or errors before submission to ensure the application is complete.
10. Save changes, download a copy for your records, and print the application if needed for submission.

Ensure you complete your CA 17A-1A application online to streamline the retake process for your pharmacist examination.