Making a declaration about your health

Use the form at the bottom of this page to tell us about any health issues which may affect your ability to provide safe and effective care, if you are a pharmacist or pharmacy technician registered with us, currently in training, or applying to join our register.

Please make sure that the information you give on the health declaration form is as accurate and detailed as possible.

You will 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 the doctor who treated you for the health issue you are declaring, and 
  • a health information form filled in by your employer completed by someone at your workplace

Download the forms to fill in on the left, and upload the completed documents in section five of the declaration. 

You may also want to include other supporting information, such as an occupational health report- this is optional.

How we use your information and next steps

All the information you provide will help us to make a decision on how to deal with your declaration. You can find out more  in our privacy policy.

When you have submitted your declaration, you will receive an email to confirm that we have received it. This will include a reference number which you can use if you need to contact us about your declaration. 

Once we have reviewed your declaration, we will be in touch to let you know about the outcome and any next steps.

Other declarations

If you would like to declare other issues that relate to your fitness to practise, such as a caution, conviction or any pending proceedings from another body, please go to the Fitness to practise declarations page.

Remember that, 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.

Health declaration form

  • Current About you
  • About your employer or training provider
  • About your condition
  • About your practice
  • Attachments
  • Declarations
  • Summary
  • Complete

About you

Are you: (this is required)


This is required

Important: when you submit your declaration, you will receive a confirmation email with your declaration submission number. If you are submitting an application, make sure you save this email and include it with your application so we can add your declaration.

Your details (this is required)



Address 1

Address 2


UK  post code


We will use your email address to communicate with you and follow up on this declaration. We won't use your email address for any other reason or purpose. We will not share your contact details with third parties. For more details please see our Privacy Policy.

Do you have any specific communication needs?
Let us know if you've got extra communication needs. This is required

Details on extra communication needs

Include details of anything we might be able to do that will make it easier for you to talk to us. We will consider all reasonable suggestions.

How will we use the information you provide

Before advancing to the next section of the form, please see our privacy policy for more details on how we will use the information you provide.

Last updated 02/05/2024