You can use this form if you are a pharmacist or pharmacy technician already registered with us to tell us about any health issues which may affect your fitness to practise.
If you have already declared a matter as part of your application to the register or your annual renewal, you do not need to declare it again unless something has changed.
If you are applying to join our register and have an issue which may affect your fitness to practise, contact our registration department on firstname.lastname@example.org or 020 3713 8000.
Please make sure that the information you give on this form is as accurate and detailed as possible.
What you need to let us know:
- as much detail about your health condition as possible
- how it affects your ability to practise as a pharmacy professional
- what treatment or advice you have had, or are getting, for your condition
- how you are managing the impact of the condition on your ability to work safely.
You should also include a Health information form filled in by your GP or doctor who has treated you and an Information from employer form filled in by someone at your workplace. You will be able to upload these at the end of the form.
You may also want to include other supporting information, such as an occupational health report.
This information will help us to make a decision on how to deal with your declaration.
If you would like to declare other fitness to practise issues such as a caution, conviction or pending proceedings from another body, please go to: fitness to practise declarations