SHPA Residency Program - Foundation Resident Registration

Congratulations on being part of the SHPA Foundation Residency.

All Foundation Residents must be SHPA members throughout the duration of their Residency. If you are not an SHPA member, please join first

Pharmacists accepted into a Foundation Residency program via an accredited Residency program site are required to register with SHPA. This is in addition to internal HR processes at your hospital.

If you require assistance completing your registration or have any questions regarding the Residency Program, please contact residency@shpa.org.au

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Your details

Preferred title:(Required)

First name:(Required)

Last name:(Required)

Email address:(Required)

Date of birth:(Required)

Gender:(Required)

Woman

Man

Non-binary

Other

Daytime phone number:(Required)

Mobile number:(Required)

Address(Required)

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

Are you an SHPA member?:(Required)

All Residents undertaking the SHPA Foundation Residency or Advanced Training Residency Program must be SHPA members for the period of the residency. If you are not a member, please join - https://www.shpa.org.au/joinrenew

Yes

SHPA member number:(Required)

Workplace details

Workplace employer:(Required)

Name of residency site

Residency program leader name:(Required)

Staff member responsible for residency program

Director of Pharmacy/Chief Pharmacist :(Required)

Date you started as a resident :(Required)

Briefly describe the personal and career goals you wish to achieve during your residency :

Internship details

Intern year (e.g. 2013 or 2014-15) :(Required)

In what pharmacy practice environment did you undertake your intern year? :(Required)

Hospital pharmacy

Community pharmacy

Industry

Academia/research

Other

If last year was not your intern year, in what pharmacy practice environment was your primary employment? :(Required)

Hospital pharmacy

Community pharmacy

Industry

Academia/research

Not applicable

Other

Registration information

Date you became a fully registered pharmacist:(Required)

Your AHPRA registration number:(Required)

Can be sourced from the AHPRA website: http://www.ahpra.gov.au/Registration/Registers-of-Practitioners.aspx

Education

University where you completed your primary pharmacy degree :(Required)

Highest tertiary qualification:(Required)

Additional to your primary pharmacy degree e.g. MPharm or write N/A where not applicable

This field is for validation purposes and should be left unchanged.