Board of Pharmacy

Various forms/applications are available for download in Adobe Acrobat   format. Simply download the form to your computer and print it out so that it can be filled out by hand or by typewriter.

If you do not have Adobe Acrobat Reader, you may download it for free from the link below.

Pharmacist Licensure Information

Information for Pharmacist License Applicants (Original, Transfer [Reciprocity], & Reinstatement)

Mail-Order/Internet/Non-Resident Pharmacy Application

Rules Regarding Mail-Order Pharmacies Doing Business In NH

Mail-Order Pharmacy Application  
(For New Registrants Only - For A Renewal Form,
Call The Board Office At: 603-271-2362)

Pharmacy Technician Registration Application

Rules Regarding Pharmacy Technicians In NH

Pharmacy Tech Application  
(For New Registrants Only - For A Renewal Form,
Call The Board Office At: 603-271-2362)

In-State Pharmacy Forms

New Pharmacy Application (NH In-State Pharmacies Only)

Important Notice for Applicants for Licensure of a NH In-State Pharmacy

Application for Licensure of a NH In-State Pharmacy
 

Amend-A-Pharmacy Permit Form

The form below is used to change the pharmacist-in-charge or to change the name of a pharmacy at a NH licensed in-state pharmacy only.

Amend-A-Pharmacy Permit Form  
(For In-State Pharmacies Only, Non-Resident / Mail-Order
Pharmacies May Report Change of Pharmacist-In-Charge
Or Pharmacy Name Change On Company/Pharmacy Letter)

Prescription Drug/Device Manufacturers/Wholesalers/Distributors or Brokers (Third Party Logistics Companies)

Complete and return this application if you are manufacturing and/or providing these products to NH entities AT WHOLESALE ONLY and not to the end-user (e.g.  a patient).

Laws Regarding Prescription Drug/Device Manufacturers/Wholesalers

Manufacturer/Wholesaler/Distributor or Broker Application
(For New Registrants Only - Renewal Forms for those currently registered, were mailed out Tuesday, May 6, 2008.

Limited Retail Drug Distributors

The Board now has 3 categories of Limited Retail Drug Distributors and there annual licensing fees are as follows:

• Limited Retail Drug Distributor (Public Health Clinic) - $150.
• Limited Retail Drug Distributor (Methadone Maintenance / Detox Facility) - $250.
• Limited Retail Drug Distributor (Medical Gases and/or Prescription Devices) - $150.

Laws Regarding Limited Retail Drug Distributors

Limited Retail Drug Distributor of Medical Gases
     and/or Prescription Devices Direct to Consumer Application
(For New Registrants Only - Renewal Forms for those currently registered, were mailed out Tuesday, May 6, 2008.

Limited Retail Drug Distributor (NH Public Health Clinic)
(For New Registrants Only - Renewal Forms for those currently registered, were mailed out Tuesday, May 6, 2008.

Limited Retail Drug Distributor (NH Methadone Maintenance/Detox Facility)
(For New Registrants Only - Renewal Forms for those currently registered, were mailed out Tuesday, May 6, 2008.