KENTUCKY Board of Pharmacy

Any form or document submitted to the Kentucky Board of Pharmacy must be submitted via Licensure Gateway if applicable or emailed to pharmacy.board@ky.gov. 

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Pharma​cist

Application for Pharmacist Certification for Opioid Antagonist Dispensing​

Kentucky Reportable Disease Form​

   Yellow Fever Vaccination Center Application​

Pharmacist Intern 

Academic Experience Affidavit 

Continuing Education

A​pplication for Pharmacist CE Approval

Application for Provider CE Approval   

​Facilities​

DEA 106 Form

Supplemental Information for Loss of Controlled Substance

Supplemental Information for Theft of Controlled Substance

Offsite Storage Request Form​​

Dual PIC Request Form

Kentucky Reportable Disease Form

​Opioid Antagonist Protocol​

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