Candidate Inquiry Subscription Personal Info - Saskatchewan College of Pharmacy Professionals

Candidate Inquiry Personal Info

Manager D#

Salutation

First Name *

Last Name *

Usual Name *

Middle Name(s)

Initials (First name initial and Middle name inital only separated by a period) *

Maiden Name

Designation

Gender

Sex at Birth

Pronouns

Languages in which you can provide services

Indigenous identity

Which of the following best describes you?

Personal Address

Address Line 1

Address Line 2

City

Country

Province/State

Postal/Zip

Care of

Home Phone

Mobile Phone will be used for two factor authentication in the future. Please make sure to provide a valid Mobile # on which you can receive SMS.

Mobile Phone

Current Membership Type

PRESCRIBING OF DRUGS - Regulatory Bylaws PART K

Prescriptive Authority (Level 1 is a Requirement of Practising membership)

Level I Prescribing Authority Training

Minor Ailments Prescribing (A Condition M will appear on your license if you do not have Minor Ailments Training)

Minor Ailments Prescribing Training

Prescriptive Authority (Level 2)

Advanced Prescribing A (A CONDITION "APA" WILL APPEAR ON YOUR LICENCE IF YOU DO NOT HAVE IT)

Advanced Prescribing B (A CONDITION "APB" WILL APPEAR ON YOUR LICENCE IF YOU DO NOT HAVE IT)

LABS (A CONDITION "L" WILL APPEAR ON YOUR LICENCE IF YOU DO NOT HAVE IT)

Your password must be at least 8 characters long and contain (capital letter, lowercase letter, number and a symbol).

Username *

Password *

Password Confirmation *