Ncbop: Fill out & sign online

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Click ‘Get Form’ to open the North Carolina Board of Pharmacy application in the editor.
Begin by filling in your personal information, including your name, North Carolina License to Practice Pharmacy Number, and NABP e-Profile Number. Ensure accuracy as this information is crucial for processing your application.
Indicate whether you are a certified vaccinator by selecting 'Yes' or 'No'. Then, provide your current address and contact details, ensuring all fields are completed.
Next, enter the pharmacy details where you will be practicing during the emergency. Include the pharmacy name, permit number, and address.
Respond to the questions regarding your licensure status in other states and any disciplinary actions. Attach necessary documents if applicable.
Review the Terms of Agreement section carefully. Sign and date it to confirm that all provided information is accurate.
Once complete, select 'Print' from the print menu and then choose 'Save as PDF' to save your application. Finally, email the completed form to emergency@ncbop.org.

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