Please note that both forms will automatically download, as you click on each of the buttons above.
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.