Pharmacist Forms

Disclosure Forms

On your APC renewal or registration application, you must disclose any conduct matters, convictions, investigations or health issues that may affect your fitness to practise.

Conduct or complaints form

Health Disclosure form
Please print and complete all sections of the relevant form and email to (preferred option) or post to The Registrar, Pharmacy Council, PO Box 25137, Wellington 6146 (mark ‘confidential’). Your application cannot be completed until full details of your disclosure have been received and assessed.

Request for Removal from the Register

If you wish to have your name removed from the Register of Pharmacists  (practising or non-practising) please make your request on this application form.

Criminal History Checks

Please note that if you are applying to register for the first time, or you are applying for reinstatement to the register you will need to submit a record of your criminal history.