Pharmacy-Based Point-of-Care Testing Training Program Interest Form

If you would be interested in attending a Pharmacy-Based Point-of-Care Testing Training Program, please complete the following secure form. You will be contacted via the email provided on this form when a program is scheduled.

Please use this form to update any incorrect fields below. Please use proper-case formatting as this information is what will appear in your record.

First Name Middle Last
Suffix
OH Pharmacist License #
Preferred Email
(Notices about any upcoming Pharmacy-Based Point-of-Care Testing Training programming will be sent via email.)

Home Address

Address
City State Zip
Home Phone Mobile
Please Check the Pharmacy-Based Point-of-Care Testing Training interest box below.
Pharmacy-Based Point-of-Care Testing Training interest
Comments
 
Please note: current OPA members have preferred registration status for this and other programs with limited seating. Thank you for your interest!
Join now at www.ohiopharmacists.org/Join
   - denotes required fields