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Iowa Board of Pharmacy

melanie.givens@iowa.gov

6200 Park Ave., Ste. 100 Des Moines, IA 50321

515-281-5088

Nontraditional Internship Approval Request

A nontraditional internship is internship training at any site which is not licensed as a general or hospital pharmacy (657 IAC 4.6(6)).

Hours obtained in a nontraditional internship will not be credited toward the total 1500 hours required pursuant to rule 657-4.3.

The Board may certify hours obtained in one or more approved nontraditional internships in recognition of the pharmacist-intern's training outside the scope of traditional pharmacy practice. 

Prior to beginning a period of nontraditional internship, the intern must submit this completed form for approval of the objectives of the nontraditional internship.

Please allow for 5-7 business days for review.  If you have any questions please contact the Board office at 515-281-5088.

Intern Demographics

Full Name

Address

    Nontraditional Internship Information

    Preceptor

    Address of Nontraditional Internship

      Start Date of Nontraditional Internship

      Anticipated End Date of Nontraditional Internship

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