Request for Continuing Pharmacy Education Credit

One CE request per application.

NOTE: Application only required for general CE programs not already approved by ACPE or for programs submitted to meet drug diversion or consulting practice CE requirement.

All applications must be received by the end of the month.
Applicants will be notified by the last Monday of each month if the program was approved, denied or if additional information is required.
If approved, continuing education (CE) certificates issued to participants must list:
- Title of the program
- Number of CE hours awarded
- WV Board of Pharmacy Program Number
- Signature of the program administrator
- Date signed
A record of the participant's attendance and copy of the CE certificate must be maintained for a period of 4 years from the program's date.
With a committee-approved CE request it is the responsibility of the provider to supply the approval code submitted by the West Virginia Board of Pharmacy to the attendees.

Provider/RPH Information


Applicant:	CE Provider	Pharmacist


Name of CE Provider:
Contact Person:			Contact Phone Number:
First Name:	Middle Initial:	Last Name:	Suffix:
Email Address:		Phone Number:	Fax Number:
Address Line 1:
Address Line 2:
City:		State:	Zip Code: