Forms

Pharmacists 

Adverse drug reaction reporting form (Health Canada)

Authorization to administer drugs by injection application

Clinical register application

Forgery report form (Health Canada)

Forgery report online form (ACP)

Letter of Standing request form

Loss or theft of narcotics or controlled drugs report form (Health Canada)

Malpractice insurance declaration and providers

PRAC ID application

Registration under the Mobility Agreement for Canadian Pharmacists (MACP) application

Statistics form

Additional prescribing authorization

Additional prescribing authorization application

Additional prescribing authorization self-assessment form

Additional prescribing authorization payment form


Students & interns

Application for Clinical Pharmacist Register

Application for Provisional Register (Canadian university students)

Application for Provisional Register (degrees from outside Canada)

Guarantor form and information

Student temporary registration form (for practicums and rotations in Alberta)

Work experience form


Pharmacy Technicians

Demonstration of proficiency of product release - notification and completion forms

Guarantor form and information

Language proficiency requirements (NAPRA)

Pharmacy Technician Register application 

Provisional Pharmacy Technician Register application

Provisional Pharmacy Technician Register application - international pharmacy technicians

Provisional Pharmacy Technician Register application - transferring from another province

Technician Structured Practical Training (SPT)

Demonstration of proficiency of product release

Pharmacy Technician SPT completion form

Pharmacy Technician post-SPT form

Pharmacy Technician SPT assessment form

Pharmacy Technician SPT notification form

Pharmacy Technician SPT pre-rotation self-assessment form

Pharmacy Technician SPT logbook

Pharmacy Technician SPT manual


Pharmacies

Add on a compounding and repackaging pharmacy licence application

Compounding and repackaging pharmacy agreement  Updated

Mail order licence add on application

Pharmacy licensee change (manager) application

Pharmacy name change application

Pharmacy practice and operations assessment guide

Pharmacy Policies and Procedures Manual template

Request to maintain records at a location other than the pharmacy

Required references

Vaccine refrigerator temperature record (Alberta Health Services)

Drug error reporting

Drug incident report form (PDF)

Drug incident report form (Word - fillable)

Sample drug incident report form

Quarterly review form (PDF)

Quarterly review form (Word - fillable)

Sample quarterly review form


Other

ACP committee candidate biographical sketch form

Credit card authorization form

Guarantor form and information

PEBC assessor recruitment form