Get California Retake Form

Get California Retake Form

The California Retake form is an essential application for individuals seeking to retake the North American Pharmacist Licensure Examination (NAPLEX) or the California Practice Standards and Jurisprudence Examination (CPJE). Completing this form accurately is crucial, as it ensures that your application is processed efficiently and without unnecessary delays. If you're ready to move forward, please fill out the form by clicking the button below.

Structure

The California Retake form is a crucial document for individuals seeking to retake the North American Pharmacist Licensure Examination (NAPLEX) or the California Practice Standards and Jurisprudence Examination (CPJE). This form, officially known as the Retake Application (form 17A-1A), outlines the necessary steps and requirements for applicants to ensure their eligibility for examination. Applicants must submit a completed application along with required documents and fees, which include a $200 fee for retaking the CPJE, while there is no fee for the NAPLEX. It is imperative that the name on the application matches identically with the name on the U.S. government-issued identification and social security card. Incomplete applications may lead to delays or abandonment of the application process. Special provisions exist for military spouses and partners, allowing for expedited review under certain conditions. Additionally, the form requires candidates to provide a Self-Query Report from the National Practitioner Data Bank if it has been over a year since their last submission. Understanding the application process and adhering to the outlined instructions is essential for a smooth retake experience.

California Retake Preview

 

 

 

 

California State Board of Pharmacy

BUSINESS, CONSUMER SERVICES AND HOUSING AGENCY

1625 N. Market Blvd, Suite N219, Sacramento, CA 95834

DEPARTMENT OF CONSUMER AFFAIRS

Phone (916) 574-7900

GOVERNOR EDMUND G. BROWN JR.

Fax (916) 574-8618

 

 

www.pharmacy.ca.gov

 

 

 

 

 

 

RETAKE APPLICATION INSTRUCTIONS

APPLICATION PROCESSING TIMEFRAME

Please allow the board 30 days to process your application. The board will mail you either your eligibility letter to sit for the examination(s) or a deficiency letter if your application is incomplete.

Due to current workload the board will not be able to respond to status checks on your application unless your application has been on file for over 60 days.

Once you have completed your requirements for licensure (passing both NAPLEX and CPJE) and your bank has processed your initial license fee check, an easy way to verify if the board has issued you a license is to visit the board’s website at www.pharmacy.ca.gov under “Verify a License”, as the processing time to receive your pharmacist wallet license is 4-6 weeks from the date the license is issued.

APPLICATION INSTRUCTIONS

Print out the entire application and required forms as instructed under What Makes an Application Complete in these instructions. Please include all the required forms prior to submitting your application to the board.

PLEASE NOTE: It is very important that when you complete the application, the name you apply under IDENTICALLY matches the name on your U.S. social security card and your U.S. government issued photo identification (state issued driver’s license or state issued identification card).

FULL LEGAL NAME

It is very important that you complete your application by applying under your full legal name. Your full legal name on record with the board is the name you submit with your pharmacist licensure examination application. The board will make you eligible only under your name on record with the board and not aliases.

In order to be admitted to take the CPJE, you will need to be prepared to display at the testing site your U.S. social security card AND U.S. government issued photo identification. Your name on both forms of identification must match letter for letter with the name of record on file with the board (e.g., if your middle name is spelled out on your U.S. government issued photo identification, then your middle name must be spelled out on your U.S. social security card, and both of these identifications must match exactly to the name of record on file with the board.) The testing site will NOT allow you to sit for the CPJE without your identifications matching IDENTICALLY with your name of record on file with the board. Photocopies of your identifications will not be accepted at the testing site.

WHAT MAKES AN APPLICATION COMPLETE Before the board can classify you as eligible to take the NAPLEX and/or the CPJE, you must submit a fully completed “Retake Application” (form 17A-1A)” along with all other required documents and fees as instructed in this section. If you have requested a score transfer to California from NABP for the NAPLEX and you have sat for the NAPLEX more than once to obtain a passing score, you are required to submit a Retake Application for each NAPLEX score in order for California to request all your NAPLEX scores to be transferred by the NABP.

APPLICATION FEE: If you are submitting a Retake Application for the NAPLEX there is NO FEE. If you are applying to retake the CPJE, please submit a check, money order, or cashier’s check in the amount of $200, made payable to the Board of Pharmacy. The application fee is non-refundable. Please check the appropriate box on the application identifying the appropriate examination(s).

RETAKE APPLICATION: (form 17A-1A): The application must be completed in its entirety-- with all questions answered. Failure to do so will result in an incomplete application and a deficiency letter will be mailed to you. Failure to correct the deficiencies will result in your application being deemed abandoned.

ACTIVE DUTY MILITARY - Spouses or Partners Receive Expedited Review: The board is required to expedite the licensure process for an applicant whose spouse or partner is an active duty member of the U.S. Armed Forces and meets other criteria. (Business and Professions Code section 115.5.) If you would like to be considered for this expedited review and process, please provide the following required documentation.

1.Are you married to, or in a domestic partnership or other legal union with, an active duty member of the Armed Forces of the United States who is assigned to a duty station in California under official active duty military orders?

If “yes,” please attach a copy of the marriage certificate or certified declaration/registration of domestic partnership filed with the Secretary of State AND military orders establishing duty station in California. For other forms of “legal union” not recognized by California, you may submit other documentary evidence of legal union issued by the State that recognizes your legal union for consideration by the board in meeting this requirement.

2.Do you hold a current license in another state, district, or territory of the United States in the profession or vocation for which you seek licensure from the board?

If “yes,” please attach a copy of the current license in another state, district, or territory of the United States.

VERIFICATION OF LICENSE IN ANOTHER STATE: If you have been issued an intern pharmacist or pharmacist license in another state since you submitted your initial pharmacist examination and license application, you must request each state board or agency to verify your license on form 17A-16. You only need to submit one form 17A-16 per state.

PRACTITIONER SELF-QUERY REPORT: If you did not provide a sealed original Self-Query Report from the National Practitioner Data Bank Healthcare Integrity and Protection Data Bank ((NPDB-HIPDB) with your initial pharmacist examination and licensure application or it has been one year since you originally submitted a sealed original Self-Query Report, you are required to submit a sealed original Self-Query Report with this Retake Application. It is your responsibility to attach the sealed original NPDB-HIPDB Self-Query Report to your application.

The instructions to request a Self-Query Report are available at NPDB-HIPDB’s website: www.npdb- hipdb.hrsa.gov. The website includes a Fact Sheet on self-querying, as well as Frequently Asked Questions to assist you in requesting a report.

Practitioner Self-Query Report requests are required to be submitted through the NPDB- HIPDB web site http://www.hpdb-hipdb.hrsa.gov. NPDB-HIPDB provides a toll-free number for individuals who do not have access to the Internet.

Practitioners are required to pay a total charge of $16.00 directly to NPDB-HIPDB.

Practitioners are required to mail to NPDB-HIPDB a notarized copy of the Self-Query request to a specified address. This copy can be printed, which the practitioner prints out after filling the form out on-line.

NPDB-HIPDB provides a dispute process for a practitioner that wish to submit a statement or dispute to a report.

The board is unable to assist you with the Self-Query process. Please contact the NPDB-HIPDB Customer Service Center at: (800) 767-6732 – TDD (703) 802-9395.

MAKE TEST ARRANGEMENTS: Please follow the below instructions for each examination.

NAPLEX: Visit the National Association of Boards of Pharmacy (NABP) Web site at http://www.nabp.net/ for information on how to register for the North American Pharmacist Licensure Examination (NAPLEX). Download the NAPLEX/MPJE Bulletin (see the NABP Web site). You must register on-line and remit the $465 fee to the NABP. You may register with NABP simultaneously when submitted your pharmacist application to the board or after the board has determined you are eligible to take the pharmacist examinations. However, the NABP will not contact you until you have registered on-line and remitted the $465 fee to the NABP. Once the board has determined you are eligible and you have paid your fee to the NABP, the NABP will mail you an Authorization to Test form (ATT). At this point, you will be able to schedule the location, date and time for your NAPLEX exam. Requirements and specifications for the NAPLEX are available in the NAPLEX/MPJE Bulletin. Additionally, there is a preNAPLEX test you may take as well to prepare you for the NAPLEX. If you have already taken and passed the NAPLEX, information on how to request a Score Transfer through NABP is on their Web site.

CPJE: You will not schedule to sit for this examination until the board has made you eligible. Please allow up to 14 days after you receive the board’s notification that you are eligible for PSI to mail you a Candidate Handbook. The outside cover of the handbook is your “Notice of Eligibility.” Use the information in this handbook to contact PSI. If you do not receive the Candidate Informational Bulletin in the mail you can download the Candidate Information Bulletin from the board’s Web site. After you have paid PSI $33, you will be able to schedule an appointment to take the CPJE. Again, the board

2

encourages you to read this handbook carefully – it contains important information about the examination and procedures at the test site.

You are encouraged to read all information published about the NAPLEX and the CPJE. Failure to comply with the testing procedures may result in your examination not being graded and forfeiting of your application and/or testing fees.

SPECIAL ACCOMMODATIONS

The California State Board of Pharmacy recognizes its responsibilities under Title II of the Americans with Disabilities Act to provide reasonable accommodations, including auxiliary aids to qualified examination candidates with disabilities. However, the board will not provide an accommodation which fundamentally alters the measurement of the knowledge or skills the examination is intended to test, compromises examination security, or creates an undue financial and administrative burden.

A candidate who seeks an accommodation has the responsibility to make the request to the board and to provide reasonable documentation of the need for accommodation at least 90 days before he or she can take the written examination. The information supplied to substantiate a candidate's request for an accommodation will be kept confidential to the extent allowed by law. Information on this process is available from the board’s Web site.

INCOMPLETE APPLICATIONS

You will be notified of any deficiencies in your application only once. It is your responsibility to correct all deficiencies. Failure to correct all deficiencies within one year from the date of notice will result in your application being deemed abandoned pursuant to Business and Professions Code section 142.

You will know that you have been deemed eligible to take the examination when you receive your “Notice of Eligibility” letter from the board.

If it has been more than 30 days since you have corrected all deficiencies in your application as identified in your deficiency letter AND you have not been notified that you are eligible to take the examinations, please contact the board via email at: intern-examstatus@dca.ca.gov.

17M-29A (1.13)

3

California State Board of Pharmacy

BUSINESS, CONSUMER SERVICES AND HOUSING AGENCY

1625 N. Market Blvd, Suite N219, Sacramento, CA 95834

DEPARTMENT OF CONSUMER AFFAIRS

Phone (916) 574-7900

GOVERNOR EDUMND G. BROWN JR.

Fax (916) 574-8618

 

www.pharmacy.ca.gov

 

RETAKE

APPLICATION FOR PHARMACIST LICENSURE AND EXAMINATION

I am submitting this application to retake: NAPLEX only

CPJE only ($200) Both CPJE ($200) and NAPLEX

(Note: There is a $200 fee (made payable to the California State Board of Pharmacy) for retaking the CPJE. There is no California State Board of Pharmacy fee to retake the NAPLEX.)

Your full legal name on file with the board must match IDENTICALLY with both your U.S. government issued photo identification and U.S. issued social security card for admission to the California Practice Standards and Jurisprudence Examination for Pharmacists (CPJE). If your identifications do not match, you will need to correct your identifications so that the names match identically. Your original U.S. government issued photo identification and U.S. issued social security card are required for admission at the CPJE examination site. All items of information requested in this application are mandatory.

Failure to provide any of the requested information will result in the application being rejected as incomplete. Pages 1, 2, and 3 of the retake application must be completed and signed by the applicant.

Applicant Information - Please Type or Print

MILITARY SPOUSES/PARTNERS (Check here if you are relocating to CA as a result of your spouse’s/partner’s active duty military service.)

Full Legal Name-Last Name:

 

 

First Name:

Middle Name:

 

Previous Names (AKA, Maiden Name, Alias, etc):

 

 

 

 

 

*Official Mailing/Public Address of Record (Street Address, PO Box #, etc):

 

 

 

City:

 

 

 

State:

 

Zip Code:

 

Residence Address (if different from above):

 

 

 

 

 

City:

 

 

 

State:

 

Zip Code:

 

Hm#: (

)

Cell#: (

)

Wk#: (

)

Email Address:

 

Date of Birth (Month/Day/Year):

 

 

**Social Security No:

 

Driver’s License No:

State:

List all state(s) where you are currently licensed or held a license as a pharmacist, intern pharmacist, and pharmacy technician. (Attach additional sheet of paper if necessary)

State

Registration Number

Active or Inactive

Expiration Date

Self-Query Report by the National Practitioner Data Bank Healthcare Integrity and Protection Data Bank (NPDB-HIPDB) Required if you have not submitted a Self-Query Report with your initial application or if it has been over one year since you last submitted a Self-Query Report to the board.

Attached is the sealed envelope containing my Self-Query Report from the NPDB-HIPDB. (This must be submitted with your application.)

THIS SECTION IS FOR BOARD USE ONLY

 

Photo:

FP Cards:

 

 

Exam History

 

 

 

 

 

 

 

 

CASHIERING ONLY

 

Security:

FP Fees:

 

Date

NAPLEX

 

CPJE

 

APPLICATION FEE

 

 

 

 

 

 

 

 

 

Receipt No.

 

Enf Check

DOJ Clear Date: _______

 

 

 

 

 

 

 

 

 

SQ-HIPDB

FBI Clear Date: _______

 

 

 

 

 

 

 

 

Date Received

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Transcript:

FG

 

 

 

 

 

 

 

 

Amount

 

 

School Code : ____

 

 

 

 

 

 

 

 

 

 

 

 

TSE

 

 

 

 

 

 

 

 

LICENSE FEE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Intern Hours:

 

 

C/I:

 

Intern Permit #

 

 

Receipt No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date Received

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LICENSURE VERIFICATION

 

 

 

 

 

 

 

 

Amount

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

License No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ALL APPLICANTS MUST ANSWER THE FOLLOWING QUESTIONS (Attach additional sheet of paper if necessary)

1.

Have you ever been expelled from a pharmacist licensure exam administered in this state or any other state?

Yes

No

 

If “yes,” provide the date and state. ___________________________________

 

 

 

2.

Have you previously taken a pharmacist exam which was not graded or had exam results

 

Yes

No

 

withheld on grounds of dishonest conduct during an examination in this state or any other state?

 

 

 

If “yes,” provide the date and state. _________________________________________

 

 

 

3.

Do you have a medical condition which in any way impairs or limits your ability to practice your profession

Yes

No

 

with reasonable skill and safety without exposing others to significant health or safety risks?

 

 

 

 

If “yes,” attach a statement of explanation. If “no,” proceed to #4.

 

 

 

 

 

Are the limitations caused by your medical condition reduced or improved because you receive ongoing

 

 

 

treatment or participate in a monitoring program?

Yes

No

 

 

 

If “yes,” attach a statement of explanation.

 

 

 

 

 

If you do receive ongoing treatment or participate in a monitoring program, the board will make an

 

 

 

individualized assessment of the nature, the severity and the duration of the risks associated with an ongoing

 

 

 

medical condition to determine whether an unrestricted license should be issued, whether conditions should

 

 

 

be imposed, or whether you are not eligible for licensure.

 

 

 

 

4.

Do you currently engage, or have you been engaged in the past two years, in the illegal use of controlled

Yes

No

 

substances?

 

 

 

 

 

If “yes,” are you currently participating in a supervised rehabilitation program or professional assistance

 

 

 

program which monitors you in order to assure that you are not engaging in the illegal use of controlled

 

 

 

substances?

Yes

No

 

 

 

Attach a statement of explanation.

 

 

 

 

5.

Has disciplinary action ever been taken against your pharmacist license, intern permit or technician

Yes

No

 

registration in this state or any other state?

 

 

 

 

 

If “yes,” attach a statement of explanation to include circumstances, type of action, date of action and

 

 

 

type of license, registration or permit involved.

 

 

 

 

6.

Have you ever had an application for a pharmacist license, intern permit or technician registration denied in

Yes

No

 

this state or any other state?

 

 

 

 

 

If “yes,” attach a statement of explanation to include circumstances, type of action, date of action

 

 

 

and type of license, registration or permit involved.

 

 

 

 

7.

Have you ever had a pharmacy permit, or any professional or vocational license or registration, denied or

Yes

No

 

disciplined by a government authority in this state or any other state?

 

 

 

 

 

If “yes,” provide the name of company, type of permit, type of action, year of action and state.

 

 

 

______________________________________________________________

 

 

 

 

 

 

 

8.

Have you ever been convicted of any crime in any state, the USA and its territories, military court or foreign

Yes

No

 

country?

 

 

 

 

 

Check the box next to “YES” if, you have ever been convicted or plead guilty to any crime. “Conviction”

 

 

 

includes a plea of no contest and any conviction that has been set aside or deferred pursuant to Sections

 

 

 

1000 or 1203.4 of the Penal Code, including infractions, misdemeanor, and felonies. You do not need to

 

 

 

report a conviction for an infraction with a fine of less than $300 unless the infraction involved alcohol or

 

 

 

controlled substances. You must, however, disclose any convictions in which you entered a plea of no

 

 

 

contest and any convictions that were subsequently set aside pursuant or deferred pursuant to sections 1000

 

 

 

or 1203.4 of the Penal Code.

 

 

 

 

 

Check the box next to “NO” if you have not been convicted of a crime.

 

 

 

 

Please provide the following information in order to assist in the process of your application: 1) certified copies of the arresting agency report; 2) certified copies of the court documents; 3) and a descriptive explanation of the circumstances surrounding the conviction (i.e. dates and location of incident and all

circumstances surrounding the incident.) If documents were purged by the arresting agency and/or court, a letter of explanation from these agencies is required. Failure to disclose a disciplinary action or conviction may result in the license being denied or revoked for falsifying the application

 

Arrest Date

Conviction Date

 

Violation(s)

Case #

Court of Jurisdiction (Full Name and Address)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

You must provide a written explanation for all affirmative answers. Failure to do so will result in this application being deemed withdrawn or incomplete.

2

APPLICANT AFFIDAVIT

You must provide a written explanation for all affirmative answers. Failure to do so will result in this application being deemed incomplete. Falsification of the information on this application may constitute grounds for denial or revocation of the license.

All items of information requested in this application are mandatory. Failure to provide any of the requested information will result in the application being rejected as incomplete.

Collection and Use of Personal Information. The California State Board of Pharmacy of the Department of Consumer Affairs collects the personal information requested on this form as authorized by Business and Professions Code Sections 4200 and 4209 and Title 16 California Code of Regulations Section 1719-1720.1 and 1728. The California State Board of Pharmacy uses this information principally to identify and evaluate applicants for licensure, issue and renew licenses, and enforce licensing standards set by law and regulation.

Mandatory Submission. Submission of the requested information is mandatory. The California State Board of Pharmacy cannot consider your application for licensure or renewal unless you provide all of the requested information.

Access to Personal Information. You may review the records maintained by the California State Board of Pharmacy that contain your personal information, as permitted by the Information Practices Act. The official responsible for maintaining records is the Executive Officer at the board’s address listed on the application. Each individual has the right to review the files or records maintained by the board, unless confidential and exempt by Civil Code Section 1798.40.

Possible Disclosure of Personal Information

We make every effort to protect the personal information you provide us. The information you provide, however, may be disclosed in the following circumstances:

In response to a Public Records Act request (Government Code Section 6250 and following), as allowed by the Information Practices Act (Civil Code Section 1798 and following);

To another government agency as required by state or federal law; or

In response to a court or administrative order, a subpoena, or a search warrant.

*Once you are licensed with the board, the address of record you enter on this application is considered public information pursuant to the Information Practices Act (Civil Code section 1798 et seq.) and the Public Records Act (Government Code Section 6250 et seq.) and will be placed on the Internet. This is where the board will mail all correspondence. If you do not wish your residence address to be available to the public, you may provide a post office box number or a personal mail box (PMB). However, if your address of record is not your residence address, you must also provide your residence address to the board, in which case your residence will not be available to the public.

**Disclosure of your U.S. social security account number is mandatory. Section 30 of the Business and Professions Code, Section 17520 of the Family Code, and Public Law 94-455 (42 USC § 405(c)(2)(C)) authorize collection of your social security account number. Your social security account number will be used exclusively for tax enforcement purposes, for purposes of compliance with any judgment or order for child or family support in accordance with section 17520 of the Family Law Code, or for verification of license or examination status by a licensing or examination entity which utilizes a national examination and where licensure is reciprocal with the requesting state. If you fail to disclose your social security account number, your application will not be processed and you may be reported to the Franchise Tax Board, which may assess a $100 penalty against you.

NOTICE: Effective July 1, 2012, the State Board of Equalization and the Franchise Tax Board may share taxpayer information with the board. You are obligated to pay your state tax obligation. This application may be denied or your license may be suspended if the state tax obligation is not paid.

MANDATORY REPORTER

Under California law, each person licensed by the Board of Pharmacy is a “mandated reporter” for both child and elder abuse or neglect purposes.

California Penal Code Section 11166 and Welfare and Institutions Code Section 15630 require that all mandated reporters make a report to an agency specified in Penal Code Section 11165.9 and Welfare and Institutions Code Section 15630(b)(1) [generally law enforcement, state, and/or county adult protective services agencies, etc.] whenever the mandated reporter, in his or her professional capacity or within the scope of his or her employment, has knowledge of or observes a child, elder and/or dependent adult whom the mandated reporter knows or reasonably suspects has been the victim of child abuse or elder abuse or neglect. The mandated reporter must contact by telephone immediately or as soon as possible, to make a report to the appropriate agency(ies) or as soon as is practicably possible. The mandated reporter must prepare and send a written report thereof within two working days or 36 hours of receiving the information concerning the incident.

Failure to comply with the requirements of Section 11166 and Section 15630 is a misdemeanor, punishable by up to six months in a county jail, by a fine of one thousand dollars ($1,000), or by both that imprisonment and fine.

For further details about these requirements, consult Penal Code Section 11164 and Welfare and Institutions Code Section 15630, and subsequent sections.

APPLICANT AFFIDAVIT

(must be signed and dated by the applicant)

I,

 

, hereby attest to the fact that I am the applicant whose signature appears

 

(Print full name)

below. I hereby certify under penalty of perjury under the laws of the State of California to the truth and accuracy of all statements, answers and representations made in this application, including all supplementary statements. I also certify that I have read the instructions attached to this application.

 

Signature of Applicant

Date

 

 

 

17A-1A (1.13)

3

Document Data

Fact Name Details
Governing Law The Retake Application is governed by the Business and Professions Code, specifically sections 115.5 and 142.
Application Fee There is no fee for retaking the NAPLEX. A fee of $200 is required for the CPJE.
Processing Time The California State Board of Pharmacy takes approximately 30 days to process the application.
Eligibility Verification Applicants can verify their license status on the board's website after processing is complete.
Identification Requirements Applicants must present a U.S. social security card and government-issued photo ID that match exactly with their application name.
Application Completeness All questions on the Retake Application must be answered. Incomplete applications will receive a deficiency letter.
Expedited Review for Military Spouses Spouses or partners of active duty military members may receive expedited processing of their application.

How to Use California Retake

Completing the California Retake form involves several steps to ensure all necessary information and documentation are provided. After submitting the form, the board will process the application and notify the applicant of their eligibility or any deficiencies. It is essential to follow the instructions carefully to avoid delays.

  1. Print out the entire Retake Application (form 17A-1A) and any required forms.
  2. Fill in your full legal name exactly as it appears on your U.S. social security card and government-issued photo ID.
  3. Provide your official mailing address and, if different, your residence address.
  4. Enter your contact information, including phone numbers and email address.
  5. Indicate your date of birth and social security number.
  6. Check the appropriate box to specify whether you are retaking the NAPLEX, CPJE, or both.
  7. If applicable, check the box for military spouses/partners and attach the required documentation.
  8. List all states where you hold or have held a pharmacist or intern license, including registration numbers and expiration dates.
  9. Attach a sealed original Self-Query Report from the National Practitioner Data Bank if required.
  10. Answer all mandatory questions truthfully, providing additional sheets if necessary for explanations.
  11. Sign and date the application to certify that all information is accurate.
  12. Submit the application along with any required fees and documents to the California State Board of Pharmacy.

Key Facts about California Retake

What is the California Retake form and who needs it?

The California Retake form is an application used by individuals who wish to retake the NAPLEX (North American Pharmacist Licensure Examination) or the CPJE (California Practice Standards and Jurisprudence Examination for Pharmacists). This form is essential for those who have previously attempted these exams but did not achieve a passing score. Completing the Retake form is necessary to ensure that your application is processed correctly and that you are eligible to sit for the examinations again.

How long does it take for the California State Board of Pharmacy to process my application?

Once you submit your Retake application, you should allow the board up to 30 days to process it. During this time, the board will either send you an eligibility letter confirming that you can take the examinations or a deficiency letter if your application is incomplete. If you have not received any communication after 60 days, you may inquire about your application status, but the board generally does not respond to status checks before that time frame.

What should I include to ensure my application is complete?

To have a complete application, you must fill out the Retake Application (form 17A-1A) entirely, answer all questions, and include all required documents and fees. If you are applying to retake the CPJE, a non-refundable fee of $200 must be submitted. For the NAPLEX, there is no fee. Additionally, ensure that your full legal name matches exactly with your U.S. government-issued photo identification and social security card, as discrepancies will result in your application being rejected.

What happens if my application is incomplete?

If your application is found to be incomplete, the board will notify you of any deficiencies only once. It is your responsibility to correct these deficiencies within one year. If you fail to do so, your application will be considered abandoned. You will know you are eligible to take the examination when you receive a "Notice of Eligibility" letter from the board.

Are there any special considerations for active duty military spouses or partners?

Yes, the California State Board of Pharmacy is required to expedite the licensure process for applicants who are spouses or partners of active duty military members. To qualify for this expedited review, you must provide documentation, such as a marriage certificate or proof of domestic partnership, along with military orders that establish the active duty member's station in California. Additionally, you must hold a current license in another state to be eligible for this expedited process.

What if I need special accommodations for my examination?

The board recognizes its responsibilities under the Americans with Disabilities Act and will provide reasonable accommodations for candidates with disabilities. However, these accommodations cannot fundamentally alter the examination's purpose or create undue financial burdens. If you require accommodations, you must submit your request and supporting documentation at least 90 days before your examination date to allow sufficient time for processing.

How can I verify my license status after submitting my application?

After you have completed all requirements for licensure, including passing both the NAPLEX and CPJE, you can verify your license status by visiting the California State Board of Pharmacy's website. Navigate to the "Verify a License" section. Keep in mind that it may take 4-6 weeks to receive your pharmacist wallet license after it has been issued, so online verification is the quickest way to confirm your status.

Common mistakes

Completing the California Retake form can be a straightforward process, but several common mistakes can lead to delays or rejection of the application. One frequent error is failing to ensure that the full legal name matches the name on the U.S. social security card and government-issued photo identification. This discrepancy can result in an application being deemed incomplete, preventing eligibility to take the examination.

Another mistake involves not submitting all required documents and fees. The application must be completed in its entirety, with all questions answered. Omitting even a single piece of information can trigger a deficiency letter from the board, which requires additional time and effort to resolve.

Some applicants neglect to check the appropriate box on the application form to indicate which examination they are applying to retake. This oversight can lead to confusion and may cause the application to be processed incorrectly. Additionally, applicants sometimes fail to attach the necessary Self-Query Report from the National Practitioner Data Bank, which is mandatory if it has been over a year since the last submission.

Another common issue arises when applicants do not provide the correct application fee. For those retaking the CPJE, a fee of $200 is required. However, there is no fee for retaking the NAPLEX. Failure to include the correct payment can result in the application being rejected.

Some individuals mistakenly believe that photocopies of identification documents will be accepted. The board requires original documents for admission to the testing site, and failure to provide these can lead to disqualification from taking the exam.

Applicants may also overlook the requirement to submit a written explanation for any affirmative answers to the questions regarding past disciplinary actions or convictions. Not providing this information can lead to the application being deemed incomplete or withdrawn.

Inadequate preparation for the testing procedures can also be a significant oversight. Not reviewing the Candidate Handbook thoroughly may result in confusion about scheduling or requirements, which can affect the ability to take the exam.

Finally, some applicants fail to respond promptly to any deficiency letters from the board. The board only notifies applicants of deficiencies once, and not addressing these within one year can result in the application being deemed abandoned. Staying proactive and organized is crucial in ensuring a smooth application process.

Documents used along the form

When preparing to submit the California Retake form, there are several other documents that may be required or beneficial to include. Each of these documents serves a specific purpose in the application process, ensuring that everything is in order for your licensure journey. Here’s a brief overview of five important forms and documents that often accompany the Retake Application.

  • Verification of License in Another State (Form 17A-16): If you hold a pharmacist or intern pharmacist license in another state, this form is necessary. It verifies your licensure status and ensures that your qualifications are recognized by the California State Board of Pharmacy.
  • Practitioner Self-Query Report: This report from the National Practitioner Data Bank is required if you did not submit one with your initial application or if it has been over a year since your last submission. It provides important information about your professional history and any disciplinary actions.
  • Application Fee Payment: While there is no fee for retaking the NAPLEX, a $200 fee is required for the CPJE. Ensure that your payment is included with your application to avoid any delays in processing.
  • Military Spouse Documentation: If you are a spouse or partner of an active duty military member, you may qualify for expedited review. Attach a copy of your marriage certificate or domestic partnership registration along with military orders to support your request.
  • Additional Identification Documents: It’s crucial that your full legal name matches on all forms of identification. Include copies of your U.S. government-issued photo ID and Social Security card to verify your identity at the testing site.

Incorporating these documents with your California Retake form can help streamline your application process. Being thorough and organized will not only make your experience smoother but also increase your chances of success in obtaining your pharmacist license. Good luck on your journey!

Similar forms

The California Retake form is an important document for those looking to retake the NAPLEX or CPJE examinations. It shares similarities with several other legal forms related to professional licensure. Here are four documents that are similar to the California Retake form:

  • Application for Licensure by Examination: Like the Retake form, this application is submitted by individuals seeking to become licensed professionals. Both forms require personal information and verification of qualifications before an applicant can take the necessary exams.
  • Score Transfer Request Form: This form allows applicants to request the transfer of their examination scores from one state to another. Similar to the Retake form, it involves a process of verification and requires the applicant to provide specific details about their previous exam attempts.
  • Application for Reinstatement: When a professional license has lapsed, this application is used to request reinstatement. It shares the need for detailed personal information and documentation, much like the Retake form, to assess eligibility for reinstatement.
  • Continuing Education Compliance Form: This form is used to demonstrate that a licensed professional has completed the required continuing education. Similar to the Retake form, it requires accurate reporting of educational activities and compliance with regulatory standards.

Dos and Don'ts

When filling out the California Retake form, it is essential to follow certain guidelines to ensure a smooth application process. Below are four things you should and shouldn't do:

  • Do ensure your full legal name matches identically on your application, U.S. social security card, and government-issued photo identification.
  • Don't leave any questions unanswered on the application form. An incomplete application will lead to delays and a deficiency letter.
  • Do submit all required documents along with your application, including the Self-Query Report if applicable.
  • Don't forget to pay the application fee if you are retaking the CPJE, as it is non-refundable and must be included with your submission.

By adhering to these guidelines, applicants can avoid common pitfalls and expedite their application process with the California State Board of Pharmacy.

Misconceptions

Misconceptions about the California Retake form can lead to confusion and delays in the application process. Here are seven common misconceptions, along with clarifications to help applicants better understand the requirements.

  • 1. There is a fee for retaking the NAPLEX. Many believe that there is a fee associated with retaking the NAPLEX. However, there is no fee for submitting a Retake Application for the NAPLEX.
  • 2. You can submit the application without all required forms. Some applicants think they can submit the Retake Application without including all required documents. Incomplete applications will receive a deficiency letter, and failure to correct deficiencies can lead to abandonment of the application.
  • 3. Photocopies of identification are acceptable. A common misconception is that photocopies of identification will suffice at the testing site. In fact, the testing site requires original identification that matches the name on file with the board.
  • 4. The application processing time is immediate. Many applicants expect quick processing of their application. The board typically takes up to 30 days to process applications, and status checks are not available until after 60 days.
  • 5. You can use an alias on your application. Some believe they can apply using an alias or a name different from their legal name. The application must match the full legal name on record with the board and identification.
  • 6. Expedited review is guaranteed for military spouses. While military spouses may receive expedited review, it is not automatic. Applicants must provide the necessary documentation to qualify for this expedited process.
  • 7. You do not need to submit a Self-Query Report if it’s been less than a year. Some applicants think they can skip submitting a Self-Query Report if they submitted one in the past year. However, if it has been over a year since the last submission, a new sealed original Self-Query Report is required.

Understanding these misconceptions can help streamline the application process and ensure that applicants are better prepared when submitting their Retake Application.

Key takeaways

Here are some key takeaways for filling out and using the California Retake form:

  • Processing Time: Expect a processing time of 30 days for your application. You will receive either an eligibility letter or a deficiency letter if your application is incomplete.
  • Application Completeness: Ensure all required forms are included. Incomplete applications will result in a deficiency letter.
  • Full Legal Name: Use your full legal name as it appears on your U.S. social security card and government-issued ID. This is crucial for eligibility.
  • Identification Requirements: Bring your U.S. social security card and government-issued ID to the testing site. Both must match your application name exactly.
  • Application Fees: There is no fee for retaking the NAPLEX, but a $200 fee is required for the CPJE. This fee is non-refundable.
  • Expedited Review for Military Spouses: If you are married to or in a partnership with an active duty military member, you may qualify for expedited processing. Documentation is required.
  • Self-Query Report: If you haven't submitted a Self-Query Report from the NPDB-HIPDB in over a year, you must include it with your application.