How To Become A Pharmacist

Transcription

1 Dear Student, Thank you for your interest in the Vernon College Pharmacy Technician Program. This program will prepare you to take the Pharmacy Technician Certification Board (PTCB) exam. The next available program will begin August 2014 and is the day program. Next night program will not start until January You will find all the necessary information to apply for the Pharmacy Technician Program within this document including program goals, salary expectations, admissions standards, and registration information. You will need to follow the admission requirements to apply for the pharmacy technician program. Please use the check list to assure that you have completed all the requirements for admission and contact the Pharmacy Technician Coordinator, Katrina Brasuell at ext 3231 or that you are in the process of applying to the Pharmacy Technician Program. Once you have completed all the admission requirements, please turn in your forms and copies to the office of the Pharmacy Technician Coordinator, Katrina Brasuell in room 2304 at Century City Campus by June 30 th of each year for the day program and by November 30 th of each year for the night program. The Pharmacy Technician Coordinator will call and schedule an appointment for the interview only after all the admission requirements have been met. After this appointment you will be informed of your status regarding the program. If you have any questions please contact the Pharmacy Technician Coordinator, Katrina Brasuell, at ext Katrina Brasuell, CPhT Pharmacy Technician Instructor/Coordinator

2 PHARMACY TECHNICIAN CERTIFICATE The Pharmacy Technician Program is a two semester program with 24 semester-credit hours for the day program and 3 semesters with 24 semester-credit hours for the night program. The student will be required to successfully complete all courses listed on the Course Schedule, which is given to the student at the time of advising with the Program Coordinator at Vernon College. Students graduate with a Certificate of Completion. The program is accredited by the American Society of Health-System Pharmacists. The classes are designed to prepare students to take the national certification exam, which is required for all Pharmacy Technician positions in Texas. A minimum grade of C must be earned in each pharmacy technician course under the Pharmacy Technician Program. All students must register with the Texas State Board of Pharmacy as Pharmacy Technician Trainees. Felony background checks are required prior to enrolling in the Pharmacy Technician Program, as well as registering with the Texas State Board of Pharmacy. Any felony conviction may hinder a student from completing the Pharmacy Technician Certificate Program. No student will be allowed to start their clinical rotation without their trainee registration from the Texas State Board of Pharmacy. CURRICULUM PHARMACY TECHNICIAN Instructional Location Century City Center CERTIFICATE OF COMPLETION (Probable Completion Time 2 semesters) Major Requirements (24 SH) Semester Hours Fall Semester (Day Program) Spring Semester (Night Program) PHRA 1102+Pharmacy Law PHRA 1102+Pharmacy Law PHRA Pharmaceutical Mathematics I PHRA Pharmaceutical Mathematics I PHRA Community Pharmacy Practice PHRA 1247+Pharmaceutical Mathematics IIPHRA Institutional Pharmacy Practice PHRA Community Pharmacy Practice PHRA 1247+Pharmaceutical Mathematics II Summer Semester Spring Semester PHRA 1445+Intravenous Admixture/Sterile PHRA IV Admixture/Sterile Compounding PHRA Institutional Pharmacy Practice PHRA Pharmacy Drug Therapy Fall Semester PHRA 2265+Practicum-Pharmacy Technician PHRA 1441+Pharmacy Drug Therapy PHRA 1243+Pharmacy Technician Certification Review PHRA Practicum-Pharmacy Technician PHRA Pharmacy Technician Certification Review + See course description for prerequisite External certifying agency Pharmacy Technician Certification Board Capstone Experience: Certification exam - PTCE

3 PHRA 1102 Pharmacy Law Survey of federal and state laws governing the practice of pharmacy. Describes the legal and ethical constraints governing technician responsibilities and pharmacist responsibilities in various settings. Special Fee: $50.00 Prerequisites: Meet TSI requirement or appropriate scores on Accuplacer and acceptance into Pharmacy Technician Program. PHRA 1209 Pharmaceutical Mathematics I Pharmaceutical mathematics including reading, interpreting, and solving calculation problems encountered in the preparation and distribution of drugs. Conversion of measurements within the apothecary, avoirdupois, and metric systems with emphasis on the metric system of weight and volume. Topics include ratio and proportion, percentage, dilution and concentration, milliequivalents, units, intravenous flow rates, and solving dosage problems. Lab Fees: $ Specialty Fee: $42.00 Prerequisites: Meet TSI requirement or appropriate scores on Accuplacer; acceptance into Pharmacy Technician Program. PHRA 1247 Pharmaceutical Mathematics I Advanced concepts of Pharmaceutical Mathematics. Topics to include ratio/proportion, conversion between pharmacy systems, aliquots, alligations, and percentages and dosage conversion. Lab Fee: $24.00; Specialty Fee: $42.00.Prerequisites: Meet TSI requirement or appropriate scores on Accuplacer; acceptance into Pharmacy Technician program. PHRA 1313 Community Pharmacy Practice Introduction to the skills necessary to process, prepare, label, and maintain records of physicians medication orders and prescriptions in a community pharmacy. Designed to train individuals in supply, inventory, and data entry. Includes customer service, count and pour techniques, prescription calculations, drug selection and preparation, over-the-counter drugs, record keeping, stock level adjustment, data input editing, and legal parameters. Lab Fees: $ Specialty Fee: $50.00 Prerequisites: PHRA 1102, PHRA 1215 and PHRA 1209 or concurrent enrollment. PHRA 1449 Institutional Pharmacy Practice Exploration of the unique role and practice of pharmacy technicians in an institutional pharmacy with emphasis on daily pharmacy operation. Topics include hospital pharmacy organization, work flow and personnel, medical and pharmaceutical terminology, safety techniques, data entry, packaging and labeling operations, extemporaneous compounding, inpatient drug distribution systems, unit dose chart fills, quality assurance, drug storage, and inventory control. Lab Fees: $ Specialty Fee: $50.00 Prerequisites: PHRA 1102, PHRA 1215 and PHRA 1209 or concurrent enrollment. PHRA 1441 Pharmacy Drug Therapy and Treatment Study of therapeutic agents, their classifications, properties, actions and effects on the human body and their role in the management of disease. Provides detailed information regarding drug dosages, side effects, interactions, toxicities, and incompatibilities. Lab Fees: $ Specialty Fee: $50.00 Prerequisites: PHRA 1301 and PHRA PHRA 1445 Intravenous Admixture and Sterile Compounding A study of sterile products, hand washing techniques, pharmaceutical calculations, references, safety techniques, aseptic techniques in parenteral compounding, proper use of equipment, preparation of sterile products, and safe handling of antineoplastic drugs. Lab Fees: $ Special Fee: $ Prerequisites: PHRA 1301 and PHRA PHRA 2265 Clinical Pharmacy Technician/Assistant Practical, general workplace training supported by an individualized learning plan developed by the employer, college, and student. Liability insurance: $22.00; Specialty Fee: $ Prerequisites: PHRA 1441 and PHRA 1445 or concurrent enrollment. PHRA 1243 Pharmacy Technician Certification Review - A review of major topics covered on the National Pharmacy Technician Certification examination. Lab Fee: $24.00; Specialty Fee: $ Prerequisites: PHRA 1441 and PHRA 1445 or concurrent enrollment.

4 Vernon College Pharmacy Technician Program Goals The Pharmacy Technician Program Goals are based on the objectives found in the ASHP Accreditation Standard for Pharmacy Technician Training Programs published in the Practice Standards of ASHP. During the Pharmacy Technician Training Program, the following objectives will be covered: Personal/Interpersonal Knowledge and Skills Demonstrate ethical conduct in all job-related activities. Present an image appropriate for the profession of pharmacy in appearance and behavior. Communicate clearly when speaking and in writing. Demonstrate a respectful attitude when interacting with diverse patient populations. Apply self-management skills, including time management, stress management, and adapting to change. Apply interpersonal skills, including negotiation skills, conflict resolution, and teamwork. Apply critical thinking skills, creativity, and innovation to solve problems. Foundation Professional Knowledge and Skills Demonstrate understanding of healthcare occupations and the health care delivery system. Demonstrate understanding of wellness promotion and disease prevention concepts, such as use of health screenings, health practices and environmental factors that impact health, and adverse effects of alcohol, tobacco, and legal and illegal drugs. Demonstrate commitment to excellence in the pharmacy profession and to continuing education and training. Demonstrate knowledge and skills in areas of sciences relevant to the pharmacy technician s role, including anatomy/physiology and pharmacology. Perform mathematical calculations essential to the duties of pharmacy technicians in a variety of contemporary settings. Demonstrate understanding of the pharmacy technician s role in the medication-use process. Demonstrate understanding of major trends, issues, goals, and initiatives taking place in the pharmacy profession. Demonstrate understanding of non-traditional roles of pharmacy technicians. Identify and describe emerging therapies. Processing and Handling of Medications and Medication Orders Assist pharmacist in collecting, organizing and recording demographic and clinical information for direct patient care and medication-use review. Receive and screen prescriptions/medication orders for completeness, accuracy, and authenticity. Assist pharmacists in the identification of patients who desire/require counseling to optimize the use of medication, equipment, and devices. Prepare non-patient-specific medications for distribution (e.g., batch, stock medications). Distribute medications in a manner that follows specified procedures. Practice effective infection control procedures, including preventing transmission of blood borne and airborne diseases.

5 Assist pharmacists in preparing, storing, and distributing medication products requiring special handling and documentation (e.g., controlled substances, immunizations, chemotherapy, investigational drugs, REMS) Assist pharmacists in the monitoring of medication therapy. Prepare patient-specific medications for distribution. Maintain pharmacy facilities and equipment, including automated dispensing equipment. Use Material Safety Data Sheets to identify, handle, and safely dispose of hazardous materials. Sterile and Non-Sterile Compounding Prepare medications requiring compounding of sterile products. Prepare medications requiring compounding of non-sterile products. Prepare medications requiring compounding of chemotherapy/hazardous products. Procurement, billing, reimbursement and inventory management Initiate, verify, and assist in the adjudication of billing for pharmacy services and goods, and collect payment for these services. Apply accepted procedures in purchasing pharmaceuticals, devices, and supplies. Apply accepted procedures in inventory control of medications, equipment, and devices. Explain pharmacy reimbursement plans for covering pharmacy services. Patient and Medication Safety Apply patient and medication safety practices in all aspects of pharmacy technician s roles. Verify measurements, preparations, and/or packaging of medications produced by other healthcare professionals (tech-check-tech) Explain pharmacists roles when they are responding to emergency situations and how pharmacy technicians can assist pharmacist by being certified as a Basic Life Support Healthcare Provider Demonstrate skills required for effective emergency preparedness. Assist pharmacist in medication reconciliation. Assist pharmacist in medication therapy management. Technology and Information Describe the use of current technology in the healthcare environment to ensure the safety and accuracy of medication dispensing. Regulatory Issues Compare and contrast the roles of pharmacists and pharmacy technicians in ensuring pharmacy department compliance with professional standards and relevant legal, regulatory, formulary, contractual, and safety requirements. Maintain confidentiality of patient information. Quality Assurance Apply quality assurance practices to pharmaceuticals, durable and non-durable medical equipment, devices and supplies. Explain procedures and communication channels to use in the event of a product recall or shortage, a medication error, or identification of another problem.

6 Career Information Career Snapshot: Pharmacy Technician (Source: U.S. Bureau of Labor Statistics) Job opportunities are expected to be good, especially for those with certification or previous work experience. Many technicians work evenings, weekends and holidays. Two-thirds of all jobs are in retail pharmacies. About The Profession Pharmacy technicians help licensed pharmacists provide medication and other healthcare products to patients. Technicians usually perform routine tasks to help prepare prescribed medication for patients, such as counting tablets and labeling bottles. Technicians refer any questions regarding prescriptions, drug information, or health matters to a pharmacist. (See the statement on pharmacists elsewhere in the Handbook.) Pharmacy aides work closely with pharmacy technicians. They are often clerks or cashiers who primarily answer telephones, handle money, stock shelves, and perform other clerical duties. (See the statement on pharmacy aides elsewhere in the Handbook.) Pharmacy technicians usually perform more complex tasks than do pharmacy aides, although, in some States, their duties and job titles overlap. Pharmacy technicians who work in retail or mail-order pharmacies have varying responsibilities, depending on State rules and regulations. Technicians receive written prescriptions or requests for prescription refills from patients. They also may receive prescriptions sent electronically from the doctor s office. They must verify that the information on the prescription is complete and accurate. To prepare the prescription, technicians must retrieve, count, pour, weigh, measure, and sometimes mix the medication. Then, they prepare the prescription labels, select the type of prescription container, and affix the prescription and auxiliary labels to the container. Once the prescription is filled, technicians price and file the prescription, which must be checked by a pharmacist before it is given to a patient. Technicians may establish and maintain patient profiles, prepare insurance claim forms, and stock and take inventory of prescription and over-the-counter medications. In hospitals, nursing homes, and assisted-living facilities, technicians have added responsibilities. They read patient charts and prepare and deliver the medicine to patients. The pharmacist must check the order before it is delivered to the patient. The technician then copies the information about the prescribed medication onto the patient s profile. Technicians also may assemble a 24-hour supply of medicine for every patient. They package and label each dose separately. The package is then placed in the medicine cabinet of each patient until the supervising pharmacist checks it for accuracy. It is then given to the patient. Pharmacy Technician Education and Training The purpose of the Pharmacy Technician program is to enable graduates to obtain basic and intermediate level competencies to obtain employment in either direct patient care or retail pharmacy settings. The Pharmacy Technology program prepares individuals to take the national Pharmacy Technician Certification Exam (PTCE) administered by the Pharmacy Technician Certification Board. Upon successful completion of this exam, the individual will be a Certified Pharmacy Technician (CPhT). Local Information Excellent opportunities exist in Wichita Falls and throughout the United States for qualified pharmacy technicians, in both hospital and other pharmacy-practice settings. Average starting pay is $9.00 to $10.00 per hour, depending on experience and qualifications. There are many opportunities for advancement and professional growth.

7 Admission Requirements Pharmacy Technician Program 1. Complete the Vernon College admission procedure. A student must be first accepted by the College before being accepted by the Pharmacy Technician Program. 2. Submit an application for admission to the pharmacy technician program. Application deadline is June 30 th for the day program beginning in August of each year and November 30 th for the night program beginning in January of each year. Applications are available from the program coordinator and on the Vernon College website. 3. The applicant needs to register with Texas State Board of Pharmacy as a pharmacy technician trainee at There is a non-refundable on-line processing fee of $ You will also have to have your fingerprints taken and this will cost approximately $45 to 50. The Texas State Board of Pharmacy will complete a criminal background check and persons with felony convictions or drug and alcohol charges may be denied registration. The applicant will not be able to enter the program without this registration. 4. All applicants will be required to take the Accuplacer Exam. You will need to take reading (minimum score of 56), math (minimum score of 49) and writing (minimum score of 66). If you have taken another entrance exam and have met the TSI requirements on that test, you will not have to take the Accuplacer Exam. 5. Provide evidence that the following immunization requirements have been met prior to enrollment in the nursing program: bacterial meningitis, tetanus/diphtheria toxoid (TD), measles (students born after January 1, 1957), rubella, mumps (students born after January 1, 1957), Tuberculosis test (TB), Varicella, and Hepatitis B (three shots). For immunization exclusions and waivers and acceptable documentation of immunizations see shot records on the pharmacy technician home page. 6. Once all the forms have been sent to the Pharmacy Technician Program Coordinator and the student meets the requirements for the program, an interview will be scheduled with the Program Coordinator. 7. The pharmacy technician admission and review committee will rank students to determine acceptance into the program based upon completion of the application process, completion of the technician trainee registration process, interview, and Accuplacer scores. 8. In the event the application is rejected by the Pharmacy Technician Admission and Review committee, the applicant may request a hearing before the College Admissions Committee. Such a request is to be submitted in writing and include reasons why the College Admissions Committee should review the petition. 9. Information regarding program standards and policies is printed in the Pharmacy Technician Handbook.

8 Pharmacy Technician Program Texas State Board of Pharmacy Registration Procedure 1. Go to the website, 2. Select Pharmacy Technician, Trainee & Applicants 3. Select Initial Technician Trainee Registration 4. Scroll to bottom and Select Click Here to Apply Be sure to fill out everything completely and accurately. If you have had any tickets or issues with law enforcement, please list them, even if they were adjudicated or when you were a minor. You will be required to complete a fingerprint session. Information on how and when to register for a fingerprint session will be ed to you as an attached pdf after you submit your application. Be sure to open attachment and follow instructions. They will not process your application without the finger prints. Monitor Application Status Online at: Once your application is approved, a certificate will be mailed to the address you entered on your application within 10 business days. Applicants are urged to refrain from calling TSBP staff regarding open applications, especially if the application is not yet approved due to criminal history. Repeated attempts to call staff further delays processing time. Applications for individuals who have a "background" must be reviewed by an in-house enforcement officer. This review process may take several months.

9 Are you ready? File an application for admission along with the $10.00 application fee. Request your final high school transcript or GED scores (for beginning freshmen) and request your college transcripts (for students with college credit) to be mailed to Vernon College Admissions. Placement Test Effective September 1, 2003, Vernon College will follow the guidelines outlined in the new statewide Success Initiative. Visit the Vernon College website at or the Vernon College catalog for more information on the Texas Success Initiative (TSI) and how it may affect your enrollment. The TSI law is also covered in New Student Group Advising. Estimate your college expenses. The Vernon College Catalog has detailed information concerning tuition and fees for each academic year, as well as housing costs at Scholarship Application. For an application, visit the Vernon College web site at For priority consideration, completed applications must be postmarked or in the financial aid office by April 1. File an application for financial aid (if needed). Apply on line at The Federal school code for Vernon College is The application process must be completed and an award letter received before July 1 in order to guarantee money at registration for fall semester. Please refer to for more information. Campus tours are available on scheduled dates by calling Student Services ext Tour dates and on line photo tours are available at

10 Participate in a New Student Group Advising Session: 1. Visit for New Student Group Advising dates/times/locations. 2. Contact a Student Services office to pre-register for a New Student Group Advising Session. Register and ensure payment arrangements for courses. Following the guidelines received through New Student Group Advising, consult the appropriate degree plan in the general catalog, check for course prerequisites in the general catalog, contact a counselor or faculty advisor for questions, and select courses from the published schedule. Log on to the Vernon College web site at choose Campus Connect and complete the registration/payment process. Special accommodations for physical, learning, or psychiatric disabilities are arranged through the Department of Special Services. Certain documentation is required. Vernon students call ext or Wichita Falls students call ext once you have decided to attend Vernon College. PASS Centers are available to help with tutoring, study skills, time management skills, testtaking strategies, etc... on the Vernon campus ( ext. 2309), Century City Center ( ext. 3257), and Sheppard Learning Center ( ext. 4210). Review Government Mandated/Consumer information such as: *Institutional Security Policies and Crime Statistics including Campus Sex Crimes Prevention (three years of on and off campus crime statistics, security policy statements and program descriptions, and procedures to be followed in cases of sex offenses), *Student Right to Know (completion and transfer rates for full time students/student athletes), *Equity in Athletics (information concerning athletic participation and financial support), *Campus Drug Prevention Program and Student Health Issues. Visit Vernon College at or contact Student Services at ext or write: Government Mandated Information Office of Student Relations 4400 College Drive Vernon, TX For your convenience, additional information for prospective students is available online at Vernon College Student Services: Vernon Campus ext. 2278

11 Century City Center ext Sheppard Learning Center ext Frequently asked questions about ACCUPLACER??? - Can I take Accuplacer instead of THEA? Yes, Accuplacer is a TSI approved placement test that can be taken instead of THEA.??? - If I only need to retake one section of THEA, can I retake that section using Accuplacer? Yes, you can use the Accuplacer to retake any section of the THEA test you might not have passed.??? - What if I don t have very good computer skills - can I still take Accuplacer? Yes, the Accuplacer test requires minimal computer knowledge, and there are basic directions at the beginning of the test.??? - If I don t pass a section of the Accuplacer test, how soon can I retest? The Accuplacer test can be taken once every 10 days.??? - Are appointments necessary? Yes. Students can reserve a seat by calling the numbers on this flyer.??? - What do students take to the exam? Students should bring a picture identification. Blank paper and a pencil are provided for the math portion of the test. No calculators, notes, books or other aids are allowed during the exam. Call if you have questions! Wichita Falls, or Vernon, Testing Coordinator Ext (WF) or 2317 (V) Counseling, Vernon Ext Counseling, Century City Ext Counseling, Sheppard Learning Center Ext. 4201

12 ACCUPLACER EXAM The high-tech solution to college placement testing Accepted alternative to THEA exam Covers reading, writing, and math (same as THEA) Completely computerized Appointments are required Test is untimed Usually takes 2 2 1/2 hours Receive test results immediately Fee is $29. Individual section or retest fee is $10 Can repeat exam every 10 days Picture ID is mandatory (driver s license, student ID, military ID, passport) Pay by check, money order, or cash All information is kept confidential Check the following websites for study material for ACCUPLACER exam Wichita Falls Testing Center Hours Mondays - 8:30 a.m. - 8 p.m. Tuesdays - 8:30 a.m. - 3:30 p.m. Wednesdays 8:30 a.m. 6 p.m. Thursdays 8:30 a.m. 6 p.m. Room 102 North Entrance, 1 st office on left 4105 Maplewood Wichita Falls, Texas (940) EXT Vernon Testing Center Hours Wednesdays 8:30 a.m. 8 p.m. Thursdays 8:30 a.m. 3:30 p.m. Wright Library (East side), Room College Drive Vernon, Texas (940) EXT Testing Coordinator Sharron Shelton sshelton@vernoncollege.edu Please call one of the phone numbers above during the appropriate hours for information or to schedule an appointment to take the Accuplacer exam in Wichita Falls or Vernon.

13 YOU MUST PROVIDE SHOT RECORDS UPON ENROLLMENT IN THE PHARMACY TECHNICIAN PROGRAM If you don t have your shot records, or shots need updating, see the Wichita Health Department, 1700 Third Street, One visit for Tetanus/diphtheria. Two visits 30 days apart for MMR. Two visits up to 72 hours apart for TB test. Hepatitis B (Series of 3). 1. Bacterial Meningitis required for all students 2. Tetanus/diphtheria (TD)- One dose of TD vaccine within the past 10 years 3. MMRa. Measles- Students who were born on or after January 1, 1957 must show proof of either two (2) doses of measles vaccine administered on or after their 1st birthday and at least 30 days apart; or at least one (1) dose of measles vaccine administered on or after their 1st birthday, must be received by students enrolled in nursing courses prior to direct patient contact and completion of the measles requirement must be accomplished as rapidly as is medically feasible; or immunity to measles (Physician-validated history or serologic confirmation). b. Mumps All students born after January 1, 1957: One dose of mumps vaccine administered on or after their first birthday, or immunity to mumps as verified by a physician-validated history, or serologic confirmation. c. Rubella One dose of rubella vaccine administered on or after the first birthday, or serologic confirmation of rubella immunity. 4. Tuberculosis test- TB test is to be taken within 6 months prior to class; results must be read and recorded on shot record. 5. Varicella - All students must show prior to patient contact proof of either one (1) dose of varicella vaccine after their 1st birthday; or if the vaccine was received prior to the 13th birthday, two (2) doses of varicella immunity, or history of varicella (chicken pox) illness validated by student, student's parents or physician. 6. Hepatitis B- All students are required to receive three doses of Hepatitis B vaccination Exclusions Medical, Religious, Military: Persons submitting a signed affidavit from a licensed physician stating immunizations would be injurious to person s health (exclusion valid for one year); or from parents or legal guardians (if person is a minor) stating immunizations would conflict with the tenets of a recognized church or religious denomination of which the person is a member (exclusion not valid during times of emergency or outbreak); or persons who document to Vernon College they are currently serving on active duty with the armed forces of the United States are exempt from this requirement. Waiver Pregnancy: Requirements for varicella, measles, rubella, and mumps vaccines are waived during pregnancy. Pregnancy is not a medical contraindication for administration of Tetanus/diphtheria toxoid, but it is best to delay until the second trimester. A student is required to provide a written note from physician stating they are not able to receive these vaccinations due to pregnancy. The student should also provide written documentation from their physician of any physical limitation they have for the duration of their enrollment in the course.

14 Pharmacy Technician Program Confidentiality Agreement As a Pharmacy Technician student, I understand that during training I will come into contact with patients, and may have access to personal information regarding their names, health conditions, diagnoses and treatments, and information regarding the staff and policies of the clinical facility. I hereby agree and affirm, by my signature below, that: 1. I will respect the confidential nature of all records, information regarding patients, and the rules and policies of clinical site(s); and 2. I will keep all such information STRICTLY CONFIDENTIAL; and 3. I will not discuss or reveal any information in any way to any person; and 4. I will not violate the state and federal Right to Privacy Act(s); and 5. I will conform to all Policies, Rules, and Regulations of Vernon College, the Pharmacy Technician program, and the clinical site(s). I understand that any violation of this Confidentiality Agreement any subject me to prosecution and can result in immediate dismissal from the course, with no refund. I, swear and affirm (Print Full Name of Student) that I have read the above and, by my signature below, do hereby agree to abide by all terms stated. Date Signature of Applicant

15 Pharmacy Technician Program Authorization for Criminal Background Search Vernon College reserves the right to conduct a criminal background search of all applicants considered for employment, students participating in work programs, and students enrolled in certain programs of study. The following information is required to proceed with the application process. By signing, you give Vernon College permission to have the Texas Department of Public Safety Crime Records Service conduct the search, and report all findings to Vernon College. This search and the findings are strictly confidential and will not be shared with any other entity. I give permission for a Criminal Background Search to be conducted. Full Name (Please Print) Maiden Name (if any) Other Name You Have Gone By (if any) Date of Birth Social Security Number Drivers License Number Signature Date

16 Pharmacy Technician Program POLICIES AGREEMENT & WAIVER OF RELEASE FROM LIABILITY I,, (PRINT YOUR NAME) hereby affirm, by my signature below, that I attest to the following: 1. I fully understand that due to the nature of the training that I shall receive, there exists the possibility of injury or infectious exposure to me, or injury or infectious exposure to others. I acknowledge and accept the fact. 2. I hereby release and agree to hold harmless Vernon College and the provider site facilities including, but not limited to their trustees, administrators, coordinators, instructors, faculty, staff, and clients/patients/fellow students from any and all liability regarding all aspects of pharmacy technician training. 3. This release shall extend to all locations considered part of the training. 4. I certify that I am 18 years of age or greater, and that I am legally competent. Date Signature of Student

17 Pharmacy Technician Admissions Check List (Please check off once completed) 1. Read and understand course requirements for completion of the program 2. Complete Vernon College application and pay $10 fee and attended a New Student Group Advising session. 3. Complete Financial Aid application (if applicable) 4. Complete application process as pharmacy technician trainee with Texas State Board of Pharmacy and bring in a copy of your registration certificate. This process could take up to 4 months to complete. You cannot be accepted into the program unless you have your trainee registration. There is a non-refundable processing fee and a fee for finger printing. 5. Make a copy of updated shot record. Shot records must include (all must be completed before application will be accepted): a. Tetanus (within the past 10 years) b. MMR (2 doses) c. Hep B (at least first dose of series of 3) d. Varicella (chicken pox) e. TB skin test 6. Mark which program you are interested in. Day program or night Program 7. Take Math Portion of Accuplacer. Reading score > 56, Math score (algebra) >49, and Writing score >66. If you have taken another entrance exam, contact the pharmacy technician coordinator to see if it qualifies. Score Reading Score Math Score Writing 8. Fill out and sign criminal back ground check (Cannot not enroll in Pharmacy Technician program with any drug related charges) (Cannot take PTCB exam with any felony convictions) 9. Sign and Date Confidentiality Agreement 10. Sign and Date Policies agreement and waiver of release from liability When packet is completed return to the office of the Pharmacy Technician Coordinator by June 30 th for the day program and November 30 th for the night program.