INTERNATIONAL PHARMACY TECHNICIAN EVALUATING EXAMINATION APPLICATION INSTRUCTIONS

Transcription

1 INTERNATIONAL PHARMACY TECHNICIAN EVALUATING EXAMINATION APPLICATION INSTRUCTIONS DO NOT SUBMIT APPLICATION INSTRUCTIONS TO PEBC WITH YOUR APPLICATION These instructions are for candidates who wish to be licensed in any of the following provinces: Ontario, British Columbia, Alberta, Nova Scotia, Newfoundland and Labrador. CONTENTS: 1. Eligibility 2. Filling Out the Application 3. Identification 4. Degree/Diploma 5. Transcript 6. Syllabus 7. License Related Documents 8. Translations 9. Having Your Documents Certified 10. Fee 11. Application Submission, Receipt and Approval 12. Applying after Previously Withdrawing or Failing an Examination 13. Changing Your Exam Centre 14. Special Needs 15. Withdrawing from the Exam 16. Refund Policy 17. Illness or Other Extraordinary Circumstances on Examination Day 1. ELIGIBILITY You must have graduated from a Pharmacy Technician or Pharmacist post-secondary program to be considered Qualifications are evaluated on a case by case basis, due to the variation in content of programs offered throughout the world You must have completed 2000 hours of work in the Field of Pharmacy within the past 36 months, some of which was completed outside of Canada 2. FILLING OUT THE APPLICATION Please neatly print or type the information required for all pages of the application. PAGE 1 GENERAL INFORMATION AND DECLARATION General Information - Be sure to fill in every required field Name - Enter all of your legal names exactly as they appear on your identification documents - PEBC will primarily communicate by , so be sure to check your regularly and make sure your settings will allow PEBC s to reach your inbox, as missed communications could prevent you from writing an exam Changes to contact information - If your contact information changes after you have sent your application you must the changes to pebcinfo@pebc.ca

2 Photos Two identical photos are required They must meet all the requirements of a passport photo (appropriate size and image likeness, with no touch ups) They must have been taken within 12 months of the exam you wish to take The date the photo was taken must be noted on the back of each photo in English or French Attach the photos in the spaces provided on pages 1 & 4 of the application, as the information on the application indicates Exam Centres Enter only one of the available exam centres listed in the Exam Dates, Centres and Fees section of the PEBC website PEBC reserves the right to cancel an exam centre at any time, most likely due to a low number of applicants for that centre Do not make your travel arrangements more than one month prior to the exam in case your centre changes PAGES 2 & 3 - DECLARATION OF COMPLETION OF REQUIRED HOURS OF WORK & DECLARATION OF PHARMACY WORK EXPERIENCE Fill in all of the information required for each pharmacy you have worked for within the past 36 months. Hours: It is essential that you record how many hours you have worked in the past 36 months in the space provided DO NOT enter your hours per week, hours since your start date, or any other variation DO NOT submit a letter in place of this form, as it will be rejected PAGE 4 THE CHECKLIST Carefully read the information on this page, as it will help you avoid common mistakes applicants make that slow down application approval or cause an exam to be missed entirely After carefully reviewing and acknowledging all of the information, fill out the information at the bottom of the page 3. IDENTIFICATION (ID) You must submit a certified copy of one of the following pieces of primary ID: Birth certificate Both sides of your Canadian Citizenship Card or both sides of your Canadian Citizenship Certificate (only if it shows all of your legal names) The personal information pages of your valid (unexpired) passport If either of the following apply to you: You do not have any of the pieces of primary ID listed because they were never issued or it is impossible to have them reissued Your primary ID does not show all of your legal names or shows a different spelling or other variation You must submit the following, as well as your primary ID, if it is available: An original statutory declaration clearly stating: All of your legal names

3 Your date of birth The reason you were either never issued any of these documents or why it is impossible to have them reissued PLEASE NOTE: PEBC does not accept copies of statutory declarations, even if they are certified Certified copies of two official, government issued documents showing: All of your legal names spelled exactly the same as in your statutory declaration Your date of birth If your name has changed from that shown on your primary ID you must also submit one of the following for each name change: Marriage certificate or divorce papers for each of your marriages showing your surname before and after the marriage, so we can connect your names in consecutive documents A change of name certificate, or the legal equivalent, from the country where you changed your name 4. DEGREE / DIPLOMA You must submit a certified copy of your college/university diploma/degree certificate: The diploma/degree certificate is the final, official document stating you successfully completed your program The name on your degree must exactly match your name as it appears on your identification 5. TRANSCRIPT You must have your college or university send your transcript directly to PEBC: Your name must appear exactly as it appears on your identification documents It must list all of the courses in your program and your grade in each course The issue date of your transcript must be within one month of the date we receive it If multiple programs contributed to your final degree, you must have a transcript sent from the college or university for each program If your college or university will not send the transcript for you, you may have a courier pick up the transcript directly from the college or university and deliver it directly to PEBC The sender s address on the document package must be the address of the college or university PEBC will reject your transcript for the following reasons: The college or university address is not recorded as the sender s address If there are documents included with your transcript that did not originate with the college/university If your transcript is sent with your application Any other indication that your transcript was not sent directly from your college/university PEBC reserves the right to conduct a source verification of your transcript by directly contacting the issuing university to confirm the information in the transcript 6. SYLLABUS ONLY IF REQUESTED BY PEBC You do not need to submit a syllabus with your initial application

4 If the college or university where you obtained your degree has not already been approved by PEBC, you will be asked to submit an official college or university syllabus from the year you graduated It must include an official listing, and brief description of the content, of every course listed in your transcript and required for your program You can send the syllabus to PEBC yourself, as it does not need to come directly from your college/university and it does not need to be certified 7. LICENCE RELATED DOCUMENTS If you have never been licensed: Submit a statutory declaration made before a notary public, commissioner for oaths or lawyer It must include this statement: I have never been licensed anywhere in the world It must provide a brief explanation of why you have never been licensed You can send the original version of this document to PEBC yourself PEBC will not accept a copy of this document, even if it is certified Your name must appear exactly as it appears on your identification documents If you are currently licensed: Have a licensing statement sent to PEBC directly from all licensing authorities you are currently licensed by It must state that you are currently licensed It must state whether your licence has ever been suspended, revoked, or if you were subject to disciplinary proceedings The issue date of the licensing statement must be within one month of the date we receive it Your name must appear exactly as it appears on your identification documents In addition to your current licensing information, you must also have all licensing authorities by which you were previously licensed send PEBC a letter stating: The period of time you were licensed by them Whether your licence was ever suspended, revoked or if you were subject to disciplinary proceedings Your name must appear exactly as it appears on your identification documents If you were previously licensed, but are no longer licensed: Submit a statutory declaration made before a notary public, commissioner for oaths or lawyer It must state the name of each licensing authority by which you have been licensed It must state whether your license was ever suspended, revoked or if you were subject to disciplinary proceedings Send the original version of this document to PEBC yourself (PEBC does not accept copies of statutory declarations, even if they are certified) Have all licensing authorities by which you were previously licensed send PEBC a letter stating: The period of time you were licensed by them Whether your licence was ever suspended, revoked or if you were subject to disciplinary proceedings Your name must appear exactly as it appears on your identification documents

5 8. TRANSLATIONS If any of your documents are written in a language other than English or French you will need to submit the following for each page requiring translation: An official translation made by a government appointed, official translator Each page of translation must include an original, official translator s stamp and signature, and the name and credentials of the official translator, all appearing in English or French Each page must be the original translation, as PEBC does not accept copies of official translations, even if they are certified 9. HAVING YOUR DOCUMENTS CERTIFIED You must have the following documents certified: The first three pages of your application All pages of your photocopied identification documents Degree/diploma Statutory declaration(s) (if applicable) You must have your documents certified by one of the following: Notary Public Commissioner for Oaths Lawyer Certifying your application: The first three pages of your application and your photo must be certified in English or French, in the spaces provided. While in the presence of your witness: Sign and date the application yourself in the space provided Have your witness enter the city, date, their name, their title or profession and sign in the spaces provided Have your witness seal, stamp or sign the photo to be witnessed. Make sure that the witness signature covers a part of the photo and the application, to ensure the photo was attached to the application at the time it was witnessed Certifying your identification and diploma/degree certificate: In English or French, each page of the copies of your documents must show the following, original information on the document itself and not on an attached page: The signature, seal or stamp of your witness The printed name of your witness The title or profession of your witness

6 10. FEES $650 CAD Pharmacy Technician Document Evaluation fee, to be submitted with your application $350 CAD Pharmacy Technician Evaluating Examination fee, to be submitted with your application Payment within Canada: Certified Canadian cheque, bank draft or money order (personal cheques and cash will be returned to you) Canadian dollars only (other currencies will be returned to you) Payable to PEBC or The Pharmacy Examining Board of Canada Currently dated (fees post-dated or more than six months old will be returned to you) Properly signed in space provided on the front of the cheque, bank draft or money order Payment outside of Canada: International money order or bank draft (cash will be returned to you) Canadian dollars only (other currencies will be returned to you) Drawn from a Canadian bank Transit number of the bank must be printed at the bottom of the bank draft or money order, using standardized coding Clearance method must be through the clearing system in Canada, not by collection An additional $50 CAD fee may be charged to cover bank charges, if the bank rejects your fee Payment from Nigeria: US dollars only if Canadian dollars are not possible (other currencies will be returned to you) Add 10% for conversion expenses, plus the difference in the exchange rate between US and Canadian dollars All other requirements are the same as for other payments made outside of Canada Fee Receipt: Your receipt is your PEBC Identification/Card of Admission, which will be sent to you 2-3 weeks prior to the exam Fee Changes: PEBC reserves the right to change the fee for the Evaluating Examination at any time, as required 11. APPLICATION SUBMISSION, RECEIPT AND APPROVAL Submission Do not deliver your application to PEBC in person because it will be rejected. Send your completed application, identification documents, degree certificate and fee to PEBC by mail or courier It is recommended that the package be sent with tracking information, so you are able to tell when it has been delivered All required documents must be received by PEBC no later than the application deadline specified in the Exam Dates, Centres and Fees section of the PEBC website

7 Receipt PEBC will send an application receipt to you within 4 weeks of receiving your application and will not respond to requests for receipt status before that time Approval You will know if you have been accepted to write the exam and will find out the exact time and centre of the exam, when you receive the PEBC Identification/Card of Admission, which will be mailed approximately 2-3 weeks prior to the exam If you do not receive this information at least 1 week prior to the exam, please send an to pebcinfo@pebc.ca 12. APPLYING AFTER PREVIOUSLY WITHDRAWING OR FAILING AN EXAMINATION You must submit a new application and fee for the next exam you wish to write All pages of the application form must be completely filled in and properly witnessed, each time you apply to take the exam, including new photos that are taken within 12 months of the exam you wish to write Do not submit your identification documents again, as they have already been verified 13. CHANGING YOUR EXAMINATION CENTRE If you wish to change your exam centre after your application has been sent: Mail or courier a written request stating your PEBC ID number, your complete name, your desire to change your exam centre and the new exam centre you have selected Attach $50 CAD payable to PEBC by certified Canadian cheque, bank draft, Canadian money order or international money order or bank draft, drawn from a Canadian bank PEBC must receive your request by the site change deadline listed in the Changing Examination Centres section of the Evaluating Examination application instructions PEBC will only be able to make the change if space is still available at the new centre you have requested 14. SPECIAL NEEDS TESTING ARRANGEMENTS If you require special needs testing arrangements because you have a physical impairment, or other disability which substantially limits one or more major life activities, or you use assistive devices such as hearing aids or a wheelchair, you must submit the Special Accomodations Request Form and supporting documents with each exam application you submit to PEBC. Should the need for special needs testing arrangements arise after submission of an application, you must contact pebcinfo@pebc.ca immediately. Written Request and Supporting Documents: Please visit for the Special Accomodations Request Form found in the International Applicants section. Review & Approval: An independent medical or other assessment of your testing needs may be required by PEBC Confidentiality will be maintained

8 Requests are assessed on an individual basis You will be contacted directly once your request has been assessed and a decision has been made Accommodations: If the accommodation is deemed appropriate, reasonable testing accommodations will be provided You will be required to sign an acknowledgement of the agreement reached with PEBC in advance of the exam date and will be bound by those conditions due to the significant cost and other resource implications of some accommodations No change will be made in the exam content or PEBC rules and policies PEBC reserves the right to assign any exam centre where the accommodation can be offered, as the exam centre requested may not be able to offer what is required 15. WITHDRAWING FROM THE EXAMINATION We must receive a withdrawal request from you no later than the last day of the exam you are withdrawing from or you will not be considered for a refund. To withdraw from an exam send an to pebcinfo@pebc.ca stating: You wish to withdraw The exam you wish to withdraw from The reason why Medical reasons for withdrawal - requirements in addition to regular withdrawal requirements: The PEBC Candidate Medical Certificate, available on the PEBC website, must be completed by a physician or nurse practitioner and dated no later than 2 business days after the exam The certificate must be received by within 5 business days of the exam, and the original, signed hard copy received by mail no later than 10 business days after the exam, or a refund will not be considered The information on the Candidate Medical Certificate will be reviewed and a decision will be made as to whether a refund is warranted - submitting a certificate within the specified timeframe does not guarantee a refund will be granted Bereavement as reason for withdrawal requirements in addition to regular withdrawal requirements: a copy of the death certificate to PEBC to verify the bereavement was at the same time as the exam The scan of the death certificate must be received by within 10 business days of the exam or a refund will not be considered Visa Refusal: Refunds are not issued due to visa refusal, so please be sure to withdraw promptly if you qualify for a refund based on the date of your withdrawal 16. REFUND POLICY Refunds are decided and processed 4 weeks after the exam takes place $30 CAD will be deducted from any refund being sent outside of Canada to cover the cost of the money order and the delivery fee A withdrawal does not count as one of your attempts

9 If you withdraw your refund will be determined by the following: DATE OF WITHDRAWAL or REASON FOR WITHDRAWAL On or before application deadline After application deadline, but more than 8 weeks prior to exam Less than 8 weeks prior to exam Failure to graduate Documented illness considered on a case by case basis Documented bereavement or compassionate circumstances - considered on a case by case basis REFUND AMOUNT PER EXAM Exam fee minus $150 CAD 50% refund No refund Exam fee minus $150 CAD Up to a 33% refund Up to a 50% refund 17. ILLNESS OR OTHER EXTRAORDINARY CIRCUMSTANCES ON EXAM DAY If you are ill or have other extraordinary circumstances (e.g., bereavement, personal emergency) prior to the exam that may affect your performance, you are strongly encouraged to withdraw before the exam begins. For details regarding PEBC s withdrawal and refund policies, please visit the PEBC website. If you start an exam and complete it while affected by illness or other extraordinary circumstances, it will count as an attempt. You cannot submit medical or other supporting documentation after completing an exam and request a No Standing on the exam. If a sudden severe illness or other extraordinary circumstances arise after starting an exam, you must report it immediately to the exam staff. If you are unable to complete the exam due to these circumstances, you may apply for a No Standing by following the procedures described below: If unable to complete the exam due to sudden severe illness after starting the exam, you must provide the PEBC Candidate Medical Certificate (available on PEBC website) verifying that you were examined at the time of the illness and the illness was confirmed. The certificate must be dated no later than two business days after the exam. The certificate must be received by within 5 business days of the exam and the original signed copy received no later than 10 business days after the exam or your case will not be considered. If unable to complete the exam due to bereavement on the day of the exam, you must provide a copy of the death certificate, verifying that the bereavement was at the same time as the exam. The death certificate must be received by within 5 business days of the exam or your case will not be considered. If unable to complete the exam due to a personal emergency after starting the exam, you must provide official documentation verifying that the personal emergency was at the same time as the exam. The documentation must be received by within 5 business days of the exam or your case will not be considered. A decision, either granting or denying the request for a No Standing, will follow in due course. Petitions received after the 7-day time period will not be considered.

10 PHARMACY TECHNICIAN EVALUATING EXAMINATION - INTERNATIONAL WITH DOCUMENT EVALUATION PEBC ID #: if previously assigned PERSONAL INFORMATION Salutation Ms. Miss Mrs. Mr. First Name & Middle Name(s) as they appear on your documents Surname(s)/Family Name(s) Former Name(s) prior to marriage or other legal name changes Apt #, Street #, Street Name, P.O. Box # Date of Birth City Province/State Postal Code Country Area Code & Cell # if applicable Area Code & Work # if applicable Area Code & Home # if applicable PHARMACY TECHNICIAN EDUCATION Name of College/University: Country of College/University: Completed: mm/yyyy MOST RECENT PHARMACY WORK SETTING select one Hospital Community Pharmacy Long-Term Care Other EXAM INFORMATION FIRST PHOTO - CERTIFIED Witness stamp/signature must cover both front of photo and application maximum size: 50 mm x 70 mm Glue one passport acceptable photo here identical to photo on 4th page minimum size: 35 mm x 45 mm Example Signature Photo must be taken within one year of exam date Select exam sitting and specify year Exam Location: choose from locations on PEBC website Select exam language Request for confirmation letter for overseas travel (visa) purposes Fall (Oct) 20 English Yes Spring (Apr) 20 French No DECLARATION I hereby declare that all the information in this application and in all documents submitted herewith is true and accurate and that the photographs enclosed are recent photographs of myself (within twelve months of the examination date). I also declare that I am the person referred to in the documents which are being submitted in support of this application. I understand that falsification of this application, submission of falsified documents to The Pharmacy Examining Board of Canada, (hereinafter referred to as the Board ), submission of falsified Board documents to other agencies, giving or receiving of assistance in answering test-items during the examination, access to test-items before or after the examination, reproduction of examination content in any manner, and/or disclosure of test-items to others, or a violation of law as stated in the Board s Rules of Conduct may be sufficient cause for the Board to bar me from the examination, to terminate my participation in the examination, to invalidate the results of the examination, to withhold my results, to bar me from future examinations, to remove my name from the Register or to take appropriate action as it sees fit, including cost recovery for all damages. If any of the events previously mentioned in this paragraph occur, I understand that any document giving the results of my examination which has been issued by the Board will be invalid and that it will be returned by me to the Board forthwith, on demand. I will conduct myself in a professional manner when interacting with the Board and examination staff before, during and after the examination. I have read and agree to follow PEBC examination policies, procedures and rules of conduct. If any document giving the results of my examination has been issued otherwise in error, I understand that the document is invalid and that I will return such document to the Board forthwith, on demand. I understand that my results will be given on a pass or fail basis only. I hereby authorize the Board to collect and use any information contained in this application for the purposes of examining and evaluating my application and examination results and to collect and use information about me from any third party source in support of such examination and evaluation. I hereby authorize the Board to disclose: any information contained in this application, any information collected or received by the Board from any source in connection with this application, and any information resulting from such examination and evaluation to any Canadian federal or provincial government, regulatory authority or investigative body, to any foreign government, regulatory authority or investigative body and to any test delivery provider or educational authority in any jurisdiction who, in the opinion of the Board, has a legitimate interest in reviewing such information. I make this solemn declaration conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath. Signature of Applicant: Witness Name: please print Witness Title / Profession: Declared before me at: city Signature of Witness: on: FOR OFFICE USE ONLY Processed Checked 0217-V1 Page 1/4

11 DECLARATION OF COMPLETION OF REQUIRED HOURS OF WORK TO BE COMPLETED BY APPLICANT I hearby declare that I applicant name please print PEBC ID# if applicable have completed 2,000 hours of work in the past 36 months in the Field of Pharmacy and in compliance with the requirements of The Pharmacy Examining Board of Canada (refer to Appendix Criteria for Field of Pharmacy ) and as indicated in the Declaration of Pharmacy Work Experience. Applicant Signature: Declared before me at: city on: Name of Notary Public/ Commissioner for Oaths/Lawyer: Signature of Notary Public/ Commissioner for Oaths/Lawyer: Name of Pharmacy #1: Address: Job Title of Candidate: Pharmacy Assistant/Technician Volunteer Date Started: Supervising Pharmacist Name: please print City: Country: Other: please specify Hours worked in past 36 months: Telephone #: Name of Pharmacy #2: Address: Job Title of Candidate: Pharmacy Assistant/Technician Volunteer Date Started: Supervising Pharmacist Name: please print City: Country: Other: please specify Hours worked in past 36 months: Telephone #: Name of Pharmacy #3: Address: Job Title of Candidate: Pharmacy Assistant/Technician Volunteer Date Started: Supervising Pharmacist Name: please print City: Country: Other: please specify Hours worked in past 36 months: Telephone #: Name of Pharmacy #4: Address: Job Title of Candidate: Pharmacy Assistant/Technician Volunteer Date Started: Supervising Pharmacist Name: please print City: Country: Other: please specify Hours worked in past 36 months: Telephone #: Page 2/4

12 DECLARATION OF PHARMACY WORK EXPERIENCE To complete this form, please circle the frequency that best corresponds to how often, on average, you performed each task listed below during your required 2,000 hours of work in the past 36 months in the Field of Pharmacy. 1 = less than once per month 2 = monthly or more often 3 = weekly or more often 4 = daily or more often I. Prescription and Patient Information Processing II. Other Pharmacy Related Tasks Task Frequency Task Frequency Assess prescriptions/medication orders for completeness Determine dispensary inventory requirements Gather patient information (e.g. allergies, medical insurance) Order inventory (medication, equipment, pharmacy supplies) Create patient medication profile Enter prescription information into patient medication profile Prepare prescription (select product, count/pour/weigh) Perform calculations (e.g., for dispensing or billing) Compound simple prescriptions (e.g., creams, ointments, reconstitute antibiotic) Prepare intravenous admixtures Package pharmaceuticals (e.g., select container, affix auxillary label) Receive ordered inventory and verify against purchase order Store pharmaceuticals under safe and appropriate conditions Remove expired or recalled products from inventory Maintain and document inventory for narcotic and controlled substances Maintain packaging, dispensing equipment and storage facilities Dispose of pharmaceuticals appropriately Refer patients to pharmacist for counselling Handle third party claims (medical insurance) Document dispensing errors (medication incidents) Applicant Signature: Declared before me at: city on: Name of Notary Public/ Commissioner for Oaths/Lawyer: Signature of Notary Public/ Commissioner for Oaths/Lawyer: Page 3/4

13 PHARMACY TECHNICIAN EVALUATING EXAMINATION - INTERNATIONAL WITH DOCUMENT EVALUATION PEBC ID #: if previously assigned CHECKLIST Use this checklist to review your application. Your application will not be accepted for this exam session unless all requirements are met by the stated deadline. Visit for complete information on each required item. PHOTOS - Two identical photos taken within one year of the exam First photo glued to page 1 of application, signed/stamped by an acceptable witness Second photo stapled to this page of the application with date taken written/stamped in English or French on back of photo PAGES 1, 2 AND 3 OF APPLICATION All names, including middle names, entered exactly as they appear on your identification documents, on pages 1, 2 and 3 address clearly and correctly filled in, as is PEBC s primary form of communication Exam sitting, year and location have been filled in All other required fields have been filled in You have signed pages 1, 2 and 3 in the presence of a witness from the acceptable witness list on the PEBC website and an acceptable witness has filled in required information on pages 1, 2 and 3 An acceptable witness has signed and/or stamped the photo on page 1 SECOND PHOTO - DATED Date is written/stamped on back of photo. Photo must be taken within one year of exam date. maximum size: 50 mm x 70 mm Staple one passport acceptable photo here identical to photo on 1st page minimum size: 35 mm x 45 mm IDENTIFICATION DOCUMENTS - Only required for first-time applicants or if your name has legally changed since your last application Certified identification: a copy of either your birth certificate, valid passport, Canadian Citizenship Card (both sides), Canadian Citizenship Certificate (both sides), or an original statutory declaration and copies of two pieces of supporting identification, have been signed and/or stamped on each page by an acceptable witness If your name has changed, a copy of your marriage certificate or change of name document has also been certified on each page by an acceptable witness COLLEGE/UNIVERSITY DEGREE CERTIFICATE A copy of your original language college/university degree certificate has been properly certified COLLEGE/UNIVERSITY TRANSCRIPT You have asked your college/university to send your transcript directly to PEBC LICENSING INFORMATION You have asked that a licensing statement be sent directly from any licensing authorities you have ever been licensed by and/or you have had a statutory declaration created to verify your current licensing status TRANSLATIONS If any document or witness information is in a language other than English or French, it has been translated by a government appointed, official translator and the original translation will be sent with the application FEE A money order, bank draft or Canadian certified cheque, in Canadian funds, for the full exam fee or the balance owing if you have money on account with PEBC, has been made payable to PEBC, signed, currently dated and will be sent with the application A money order, bank draft or Canadian certified cheque, in Canadian funds, for the full document evaluation fee or the balance owing if you have money on account with PEBC, has been made payable to PEBC, signed, currently dated and will be sent with the application (you can include both fees in one payment) REFUND POLICY You have read and understand the PEBC withdrawal and refund policy found in the application instructions on the PEBC website I confirm that all of the above requirements have been met. I understand that my application will not be accepted unless all requirements are met by the application deadline: Applicant Name: please print Applicant Signature: Mail to: PEBC, 717 Church St. Toronto, ON, M4W 2M4 - Do not mail application instructions or appendix Page 4/4

14 APPENDIX: CRITERIA FOR FIELD OF PHARMACY Do not submit this page to PEBC with your application The field of pharmacy includes practice where some of the following tasks are performed: PRESCRIPTION AND PATIENT INFORMATION PROCESSING Creating and maintaining patient records Receiving and transferring prescriptions or requests for prescription refills, including assessing prescriptions for clarity, completeness, authenticity and legal requirements Preparing products for release and/or distribution, including: Product selection Retrieving, counting, pouring, weighing, measuring, compounding and reconstituting sterile and non-sterile products Packaging products to maintain integrity, including selecting type of prescription container, prepackaging medications and affixing prescription and auxiliary labels Releasing and distributing products in a manner that ensures patient safety COMMUNICATION AND EDUCATION Communicating with patients, patients agents, pharmacists, other pharmacy technicians and other members of the health care team, and educating, where appropriate, in order to promote and support optimal patient care and well-being MANAGEMENT Managing operations, administrative activities and financial elements associated with the processing of prescriptions OTHER RELATED PHARMACY SERVICES Generating patient care data (i.e. medication administration record, medication review) Managing systems for drug distribution and inventory control to ensure patient safety and the safety, accuracy, quality, integrity and timeliness of the products, including: Determining and maintaining inventory requirements Auditing inventory and documenting discrepancies for narcotic, controlled and targeted-controlled substances Maintaining drug information files Maintaining packaging and dispensing equipment and storage facilities Replenishing medications for nursing units, night cupboards, emergency boxes and cardiac arrest kits PROFESSIONAL COLLABORATION AND TEAMWORK Working in collaborative relationships within health care teams to optimize patient safety and improve health outcomes QUALITY ASSURANCE Collaborating in developing, implementing and evaluating quality assurance and risk management policies, procedures, and activities related to the safe use of medications and the safety and integrity of pharmaceutical products Note: These criteria are adapted from NAPRA s Professional Competencies for Canadian Pharmacy Technicians at Entry to Practice and eligibility criteria for admission into the OCP Pharmacy Technician Certification Examination.