Forms

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  Form   Description
Conduct Charge Statement Submit a conduct complaint against a PTCB candidate or certificant.
CPhT-Recognized Education/Training Program (REP) To request recognition of your education/training program, submit the form.
CSPT® Competency Attestation Form This form is required to be submitted annually with your CSPT renewal.
CSPT-Recognized Education/Training Program Submit a help request.
Emergency Withdrawal Request Form If you experience an emergency on the day of your exam, you may submit this form within 48 hours after the end of your exam authorization.
Item Writing Volunteer Form If you are interested in assisting in writing exam items for the Pharmacy Technician Certification Exam, complete the form.
Name change Follow the instructions in this Help Center article.
PTCB Misconduct Disclosure Checklist Form Self-disclose a misconduct case.
PTCE® Preparation Attestation Form If you have taken the PTCE four or more times, submit this form to provide proof of your preparation.
Reapplication Petition Form Submit a reapplication petition after certification revocation.
Request for Testing Accommodations Form Review the Pearson Comfort Aid List to see the items allowed in the testing center without pre-approved testing accommodations.
Supervisor Attestation Form for the PTCB Billing and Reimbursement Certificate Program Required when applying for the Billing and Reimbursement Certificate.
Supervisor Attestation Form for the PTCB Medication History Certificate Program Required when applying for the Medication History Certificate.
Supervisor Attestation Form for the PTCB Nonsterile Compounding Certificate Program Required when applying for the Nonsterile Compounding Certificate.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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