Application for Kiosk or Remote Dispensing Pharmacy Permit

Instructions

Instructions

Applicable Statutes and Rules

Supervising Pharmacy

Kiosk or Remote Pharmacy Information (as applicable)

Regulatory Questions

Supervising Pharmacist Information

Attachments

Review Your Information

Affirm And Submit

Please note that after you click the Submit button, you cannot make changes to your application.

Mailing Address: P.O. Box 18520, Phoenix, AZ 85005 Phone: (602) 771-2727