Pharmacist Skills checklist

Personal Information

Please fill the Recruiter Email correctly for successful application submission.

Candidate Name

Email of Recruiter / POC

Select Submission Date

SSN (Last 4 digits)

Proficiency Scale & Legend

1 No experience

2 Need Training

3 Able to perform with supervision

4 Able to perform independently

Practice Settings/experience

Academia

Ambulatory Care

Clinic

Compounding

Consulting

Correctional Facility (Jail)

Diabetes

Drug Information

Formulary Management

Geriatrics

Home Health

Home Infusion

Hospital-Inpatient

Hospital-Outpatient

Infectious Disease

Long Term Care (LTC)

Mail Order

Military/Government/VA

Nuclear

Oncology

Pain Management

Pediatrics

Pharmaceutical Research

Pharmaceutical Sales

Pharmacy Benefits Management (PBM)

Poison Control

Psychiatric Patient Management

Public Health

Renal Patient Management

Retail-Chain

Retail-Independent

Sub-Acute Care

Veterinary

Pharmacy Software Systems

Automation

Disease State Management

Clinical And Job Related Experience

Age Specific Competencies

Pharmacokinetic Dosing

*Please enter information you feel is important or necessary to give further explanation for information provided above:

I have filled out this skills checklist to the best of my knowledge and agree that all the information provided is correct, and that any misrepresentation or falsification of fact may be considered sufficient cause for immediate dismissal from the agency.