Nomination Form - For those responding to being nominated by someone else
Please fill out this form if you are responding to someone else nomintaing you. If you are nominating someone else, please use the
'Nominating somebody else'
form. If you are nominating yourself, please use the
'Nominating yourself'
form.
Title:
Mr
Ms
Mrs
Miss
Me
Dr
First Name:*
Last Name:*
Contact Phone:*
Email:
Current Pharmacy
employed at:*
Position:
Pharmacy Address 1:*
Pharmacy Address 2
Suburb:*
Post Code:*
State:
Queensland
New South Wales
Victoria
South Australia
Western Australia
Tasmania
Australian Capital Territory
Northern Territory
Employer Name:
Total length of time working within Pharmacies:
Years
Months
Areas of Expertise:
Front of shop
Dispensary
Vitamins
Diabetes
Management
Scheduled medicines
Quality Care Co-ordinator
Point of Sale
Cosmetics
Qualifications achieved:
Certificate I in Community Pharmacy
Certificate II in Community Pharmacy
Certificate III in Community Pharmacy
Certificate IV in Community Pharmacy
Retail Certificate I
Retail Certificate II
Retail Certificate III
Retail Certificate IV
Retail Certificate Diploma
Dispensary Course
Other (please specify):
Selection Criteria
The following statements are designed to characterise traits of a pharmacy assistant who displays leadership, skills and knowledge of the pharmacy industry and who exhibits a true commitment to leading pharmacy and pharmacy assistants into the future.
Please respond in 150 words or less to the each of the following statements, demonstrating how you apply each statement to your own personal experience within pharmacy.
1. Describe your most rewarding experience during your career as a Pharmacy Assistant.
2. In your opinion, what are the most significant changes that have occurred in the Pharmacy Industry recently?
a. How have these changes impacted on you, your customer and your pharmacy?
3. What is a point of difference of your pharmacy? What makes your pharmacy stand out from other pharmacies?
4. QCCP accredited Pharmacies are mystery shopped every year. The mystery shopper will record whether the pharmacy staff member/s gathered enough information to ensure safe and appropriate selection of the medicine and provided sufficient information for the safe and effective use of the medicine. The ‘what, stop, go” protocols aid with gathering and providing this information to customers.
a. Please give an example of a positive outcome that you have experienced with a customer when you applied these questioning protocols.
I acknowledge that I have READ and AGREED to abide by the rules and conditions of entry.
(printable version)