Edit, Download, and Sign the NABP Name Change Form Instructions and Guide
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How do I fill this out?
To fill out this form, start by clearly writing your current name and the name you wish to change to. Provide necessary information such as your date of birth and NABP e-Profile ID. Finally, ensure you have the form notarized before submission.
How to fill out the NABP Name Change Form Instructions and Guide?
1
Clearly write your current name and new name.
2
Provide your date of birth and NABP e-Profile ID.
3
Complete the required signature and date fields.
4
Have the form signed by a notary public.
5
Submit the notarized form along with any required documents.
Who needs the NABP Name Change Form Instructions and Guide?
1
Pharmacists changing their legal name for professional records.
2
Technicians updating their name after marriage or divorce.
3
Individuals applying for a new license requiring a name update.
4
Foreign pharmacy graduates needing to amend their application.
5
Anyone with an NABP e-Profile requiring accurate name information.
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3
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Review the document for accuracy and completeness.
5
Save your finalized form for submission.
What are the instructions for submitting this form?
To submit the NABP name change form, send it via mail to NABP Customer Service at 1600 Feehanville Dr, Mount Prospect, IL 60056 or fax it to 847/375-1114. Ensure you include a photocopy of your name change documentation, such as a marriage certificate, divorce decree, or court order. It's recommended to keep a copy of the completed form for your records.
What are the important dates for this form in 2024 and 2025?
Check back in 2024 and 2025 for any anticipated updates or deadlines regarding the NABP name change process.
What is the purpose of this form?
The primary purpose of the NABP name change form is to update the official records of licensed pharmacists and technicians. This ensures that all professional credentials accurately reflect the individual's current name. Submitting this form is crucial for maintaining compliance with NABP regulations and ensuring smooth operation of professional affairs.
Tell me about this form and its components and fields line-by-line.
- 1. Your Current Name: The name currently associated with your NABP e-Profile.
- 2. New Name: The name you wish to have updated in your profile.
- 3. Date of Birth: Your date of birth for identification.
- 4. NABP e-Profile ID: Your unique e-Profile identification number.
- 5. Signature: Your signature confirming the provided information.
- 6. Notary: Signature and information of the notary public who verifies the form.
What happens if I fail to submit this form?
Failing to submit the NABP name change form can result in delays in updating your professional credentials. This could affect your ability to practice under your current name. It's important to ensure all requirements are met to avoid complications.
- Delay in Profile Update: Your name may not be updated in the NABP system, delaying your professional activities.
- Regulatory Compliance Issues: Using an incorrect name could lead to compliance issues with regulatory bodies.
- Possible License Suspension: Failure to submit accurate information could result in disciplinary action or suspension.
How do I know when to use this form?
- 1. Marriage: When you change your name due to marriage, use this form to update your profile.
- 2. Divorce: If you revert to a previous name after divorce, submit this form.
- 3. Court Order: Use this form if you have legally changed your name via court order.
- 4. Professional Requirement: Ensure your name on professional documentation matches your NABP profile.
- 5. Consistent Record Keeping: To maintain accurate records with regulatory entities, use this form.
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What information do I need to provide?
You'll need to provide your former name, new name, date of birth, and NABP e-Profile ID.
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