Get the free Pharmacy Change of Name Form.docx

FLORIDA BOARD OF PHARMACY 4052 Bald Cypress Way, Bin C-04 Tallahassee, FL 32399-3254 Phone: (850) 245-4292 www.doh.state.fl.us/pharmacy PHARMACY PERMIT NAME CHANGE From A pharmacy permit is valid

How to fill out pharmacy change of name

How to fill out a pharmacy change of name:

1. Obtain the necessary forms: Contact your local pharmacy board or regulatory agency to request the appropriate forms for changing the name of your pharmacy. These forms may vary depending on your location, so ensure you have the correct ones.
2. Gather required documentation: Typically, you will need to provide proof of the name change, such as a marriage certificate, court order, or official documentation from a government agency. Additionally, you may be required to submit identification documents, such as a driver's license or passport.
3. Complete the forms: Carefully fill out all sections of the change of name forms. Provide accurate information and double-check for any errors or missing details. Include any additional requested information, such as your current pharmacy license number or unique identifiers.
4. Review and sign the forms: Once completed, review the forms thoroughly to ensure accuracy. Verify that all information is correct and consistent. Sign the forms using your current legal name, and if required, have them notarized.
5. Submit the forms: Send the completed forms, along with any required documentation and fees, to the designated address provided on the forms or guidelines. Use certified mail or a secure delivery method to ensure that your submission is received.
6. Follow up: After submitting the forms, follow up with the pharmacy board or regulatory agency to confirm that they have received your application. Keep a record of any correspondence or confirmation receipts.
7. Await approval: The pharmacy board or regulatory agency will review your application and documentation. This process may take some time, so be patient. If additional information or clarification is needed, they will contact you.
8. Notification of approval: Once your pharmacy change of name is approved, you will receive official notification from the pharmacy board or regulatory agency. This notification may include a new pharmacy license or certificate with your updated name.

Who needs a pharmacy change of name:

1. Pharmacists undergoing a legal name change due to marriage or divorce.
2. Pharmacy owners or operators rebranding their business and changing the name accordingly.
3. Pharmacy corporations or entities merging with another company and adopting a new name.
4. Pharmacies relocating to a different jurisdiction/state/country may need to change their name to comply with local regulations.

Remember, the specific requirements for a pharmacy change of name may vary depending on the jurisdiction and regulatory agency overseeing your pharmacy. It is important to consult your local pharmacy board or regulatory agency for accurate and up-to-date information.

For pdfFiller’s FAQs

What is pharmacy change of name?

Pharmacy change of name is the process of a pharmacy updating or modifying its legal name to reflect any new ownership or business structure.

Who is required to file pharmacy change of name?

Pharmacies that have undergone a change in ownership or business structure are required to file for a pharmacy change of name.

How to fill out pharmacy change of name?

To fill out a pharmacy change of name, pharmacies need to submit the necessary forms and documentation to the appropriate regulatory agency.

What is the purpose of pharmacy change of name?

The purpose of a pharmacy change of name is to ensure that regulatory agencies and consumers are informed of any changes in ownership or business structure.

What information must be reported on pharmacy change of name?

Pharmacies must report their old legal name, new legal name, reason for the name change, and any supporting documentation.

Can I create an electronic signature for the pharmacy change of name in Chrome?

Yes. You can use pdfFiller to sign documents and use all of the features of the PDF editor in one place if you add this solution to Chrome. In order to use the extension, you can draw or write an electronic signature. You can also upload a picture of your handwritten signature. There is no need to worry about how long it takes to sign your pharmacy change of name.

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