GPhC accredited Accuracy checking for dispensers enrolment form

This enrolment form is for NPA members, if you are currently not in membership with the NPA please initially contact our Members Services team on 01727 800402. This form must be completed by the supervising pharmacist.

Student details

Title*

First name:*

Surname:*

Email Address*

Please ensure this email address is unique to the candidate, we will use this for the purpose of contacting the student.

Date of birth*

Has the student completed a GPhC accredited Level 2 dispenser's qualification or do they have equivalent experience?*

Yes

Please provide the date the certificate was issued*

Date of enrolment for your student*

PLEASE NOTE: that their certificate must have been issued at least 6 months prior to your chosen date of enrolment

Please attach a copy of the student's accredited Dispensing Assistant course certificate. Alternatively, if you are applying with equivalent experience, please upload a document that provides a breakdown of this experience.*

Accepted file types: jpg, png, gif, pdf, doc, docx, Max. file size: 128 MB.

[Please note: photographs are acceptable as long as the entire certificate is within clear view]

Please upload a dispensing log of 200 items dispensed with no error to confirm the candidates suitability for this course.*

Accepted file types: jpg, png, gif, pdf, doc, docx, Max. file size: 128 MB.

Supervising Pharmacist details

Title*

First name:*

Surname:*

GPhC number:*

Supervising Pharmacist's Email Address*

Please note: this must be an email address that can only be accessed by yourself, not a branch email address. Important: To comply with GDPR, please ensure this email address is not shared and is unique to the pharmacist.

NPA Membership number:

Pharmacy name

Pharmacy Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

I confirm that:*

I am the permanent supervising pharmacist of this student and have discussed the implications and limitations of this training and the role with the student and consider them to be a suitable candidate .

The candidate has been a qualified dispenser for 6 months minimum (we advise this to be a minimum of 14 hours/week) and I believe that they have the correct behaviours and skills to become an accuracy checking dispensing assistant.

I have attached the dispensing log of 200 items dispensed with NO ERRORS to confirm the candidates suitability for this course.

I am willing to support the student throughout the training.

I have carried out a personal assessment of the student’s capabilities.

I understand that upon certification, although the certificate demonstrates achievement of competence to GPhC accredited standards for accuracy checking, should the ACD move employment (whilst the two year certificate is still in date) the ACD is strongly advised to complete a transfer portfolio. I confirm that I have read and will comply with Appendix 13 of the Terms & Conditions accessible via the link in the Terms of Service below.

I understand that the trained accuracy checking dispensing assistant will need to complete and submit a portfolio every two years, to remain certified as an accuracy checking dispensing assistant only within a community pharmacy setting.

How did you hear about this course?*

If Other, please provide more details:

Important Information

Data Protection Notice

It is important that you understand how the personal information you give us will be used. Therefore, we strongly advise that you read our Privacy Statement, which you can find at Privacy Notice.

Terms of Service*

Read our full Terms and Conditions here.

I agree to the Terms of Service

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Phone

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