UWA Subsidised Places

Graduate Certificate in Quality Use of Medicines and Prescribing

Please complete this expression of interest for the course subsidy of our Graduate Certificate in Quality Use of Medicines and Prescribing.

Preferred Name*

Last Name*

Email Address*

Mobile Phone*

I am an Australian registered pharmacist*

Only Australian registered pharmacists are eligible.

AHPRA Registration Number*

Australian Health Practitioner Regulation Agency (AHPRA)

Gender

Are you of Aboriginal or Torres Strait Islander origin?

Pharmacy Board of Australia registration status

Date first registered with Pharmacy Board of Australia

Postcode of suburb where you live*

Postcode of suburb of the community pharmacy where you work*

What is the name of the Western Australian community pharmacy in which you work?

If you work in more than one, list the one you work in most regularly. For locums, list the region in which you locum.

How many hours a week do you work in a Western Australian community pharmacy?

How long have you worked in this community pharmacy?

Do you have any further comments or interest in doing this course?

By opting-in I am able to and understand that I am voluntarily consenting for UWA to collect and use my personal information for the purposes of Direct Marketing communications, in accordance with the UWA Privacy Policy (linked below). I understand that I may opt out at any time by advising UWA.

I opt-in to receive marketing communications from UWA.

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