Pharmacist Reinstatement Form REINSTATEMENT FORMFirst Name *Middle NameLast NamePharmacist´s Reg# *Gender *MaleFemaleDate Birthday *Current Address *Telephone Number *Email Address *I hereby declare that I have completed all the requirements for reinstatement on the Register of Pharmacists in Jamaica.Signature *Start signing your signature hereYour browser does not support e-Signature field.Pharmacist Applying for ReinstatementSignature *Start signing your signature hereYour browser does not support e-Signature field.Preceptor/Reg. No.LocationSupervising PharmacistPeriodLocationSupervising PharmacistPeriodLocationSupervising PharmacistPeriodSignatureStart signing your signature hereYour browser does not support e-Signature field.Submit Form Applicants have the option to either fill out the form below or download it for completion. Download Form