Pharmacist Intern Registration Requirements & Application
Pharmacist Intern Requirements & Application
Practical experience requirements for registered pharmacist interns in Indiana may be satisfied by complying with either of the following:
- Completion of the practical experience requirements of the college of school of pharmacy from which the intern has graduated, if the curriculum of the college or school has been accredited by:
- The American Council on Pharmaceutical Education (ACPE);
- The Canadian Council on Pharmacy Accreditation
- another board approved practical experience program.
- In the event the intern has graduated from a non-accredited program or has no practical experience as a part of their curriculum, the intern must complete a minimum of 1,500 hours of practical experience under the supervision of a pharmacist.
- All portions of the application must be completed in full; incomplete applications will be returned to you. NOTE: Pursuant to IC 4-1-8-1 (10), providing your social security number is mandatory.
- Attach a recent head and shoulder color 2" x 2" photograph of yourself. NOTE: Photos must be of passport quality.
- Include a personal check, money order, or certified cashier's check made payable to "Professional Licensing Agency" for $10.00.
- The section entitled "Certificate of Enrollment or Graduation in Pharmacy Education" must be completed and signed by the Secretary or Dean of the School of Pharmacy of which you are currently enrolled or are a graduate. NOTE: Applicants who are graduates of a pharmacy program outside the United States do NOT need to have this section completed; you are required to submit proof of their Foreign Pharmacist Graduate Examination Committee (FPGEC) Certificate. There are no exceptions to the FPGEC Certificate.
- "Sponsor's Statement and Affidavit" section must be completed as follows:
- applicants who are currently enrolled in an ACPE accredited program and are obtaining the intern registration in order to complete rotations, the secretary or dean of the pharmacy program may check off in the appropriate box and sign the form in place of a registered pharmacist;
- applicants who are currently enrolled or a recent graduate of an ACPE accredited program and are obtaining this registration in order to earn additional intern hours in Indiana, an employer or sponsor who is an Indiana licensed pharmacist may check off in the appropriate box and sign the form;
- applicants who are graduates from a non-accredited program must have an employer or sponsor who is an Indiana licensed pharmacist to check off in the appropriate box and sign the form. Since graduates of non-accredited programs do not have the "Certificate of Enrollment or Graduation" section completed, the "Sponsor' Statement and Affidavit" is required to be completed in full and the application cannot be processed without this information.
- Sign and date the application in the appropriate sections.
- If you have responded YES to any of the questions concerning discipline, charges, convictions, etc., you must submit a notarized statement describing your response in detail, including he location,date, and disposition and you must submit the following, depending on which question(s) you responded YES:
Documentation Required for “Yes” Responses on Page 1 of the Registration Application
Question #1: Copies of all Board orders filed against the license. If action has been lifted against your license, then verification of this is required as well.
Question #2: Submit a copy of the denial notification as well as any other documentation relating to the denial.
Question #3: Submit all related court documentation that indicate charges pending against you, court dates, and any other documentation you may have.
Question #4: Submit all related court documentation that indicate the charge, plea, sentence requirements, and, if the sentence requirements have been met, verification of completion of sentencing requirements. You should request a chronological case summary.
Question #5: Submit a current evaluation from an approved addictionologist.:
Send your completed application, $10 fee, and any other supporting documentation to the following address:
Professional Licensing Agency
Indiana Board of Pharmacy
402 W. Washington St., Room W072
Indianapolis, IN 46204
- The pharmacist intern registration will be issued up to the next current expiration date and upon renewal will then be valid for a period of one (1) year thereafter. All intern permits shall expire on September 30th; renewal information will be emailed to the email address we have on record (so keep yours updated) those that do not have an email address will receive a mailed notice to the address of record ninety (90) days prior to expiration.
- The period of experience shall be computed and credited from the date the pharmacist intern registration is issued, with no credit given for any experience in pharmacy prior to registration issuance.
- The acceptable pharmacist intern practical experience time must be verified by submitting to the Indiana Board of Pharmacy the "Affidavit of Experience" which is signed at the termination of each period of practical experience. All affidavits must list all practical experience time on a calendar week basis showing actual time served each week. Acceptable practical experience time per week shall consist of not less than four (4) hours and not more than sixty (60) hours per week.
- Practical experience time served in another state will be accepted if the following requirements are met: (1) the practical experience time serviced in such other state meets all requirements of Indiana law and is experience time of the type that is acceptable to the Indiana Board of Pharmacy and (2) The applicant has a valid intern license from the state where the experience is served. These hours must be verified from the other state to the Indiana Board of Pharmacy.
- Prior approval is required for experience in a site other than a pharmacy. A written request must be submitted to the Board prior to beginning the experience period.