Expression of Interest - Pharmacist relief workforce
1.
Surname
2.
First name(s)
3.
Pharmacy Council Registration number
4.
email address
5.
contact phone number
6.
Which DHB do you currently reside in?
Northland
Waitemata
Auckland
Counties Manukau
Waikato
Taranaki
Bay of Plenty
Tairawhiti
Hawkes Bay
Lakes
Whanganui
Mid Central
Wairarapa
Hutt Valley
Capital and Coast
Nelson Marlborough
Canterbury
South Canterbury
West Coast
Southern
7.
Are you also available to work outside your DHB of residence?
Yes
No
8.
If so, which DHB(s) are you available to work in?
Northland
Waitematā
Auckland
Counties Manukau
Waikato
Taranaki
Bay of Plenty
Tairāwhiti
Hawkes Bay
Lakes
Whanganui
Mid Central
Wairarapa
Hutt Valley
Capital and Coast
Nelson Marlborough
Canterbury
South Canterbury
West Coast
Southern
I am not available to work outside my DHB of residence
9.
Approximately how many hours per week are you available to work?
less than 8 hours per week
8-24 hours per week
24-40 hours per week
more than 40 hours per week
10.
Most recent area of clinical practice
community pharmacy
hospital pharmacy
primary care pharmacy
Other (please specify)
Current Progress,
0 of 10 answered