Pharmacist (PM Shift)

Personal Information Full Name * Address * City, State, ZIP * Phone Number * Email Address * Preferred Contact Method * Phone Email Position Details Position Applying For: * Pharmacist (PM Shift) Preferred Work Schedule * Day Shift Evening Shift Weekend Full-Time Part-Time Available Start Date * Willing to work across multiple locations? * SelectYesNo Licensure & Certification State of Ohio Pharmacist License Number: * License Status * SelectActivePendingInactive Expiration Date DEA Registration Number * DEA Registration Status * ActivePending NPI Number (if applicable) Immunization Certification * SelectYesNo MTM (Medication Therapy Management) Certified * SelectYesNo CPR/BLS Certification * SelectYesNo CPR/BLS Certification Expiration Date (If Applicable) Are you authorized to work in the U.S.? * YesNo Education School/Institution * Degree * Year Completed * Residency or Fellowship Training * PGY-1 PGY-2 Fellowship None Professional Experience If applicable, specify area of specialization: Most Recent Employer Job Title Start Date End Date Supervisor Name/Title Contact Number Primary Responsibilities Practice Setting Retail/Community Pharmacy Hospital/Clinical Pharmacy Urgent Care/Ambulatory Compounding Pharmacy Other May we contact this employer? SelectYesNo Clinical & Technical Skills Medication verification and dispensing accuracy Patient counseling and education Immunization administration Medication Therapy Management (MTM) Controlled substance and DEA compliance Pharmacy operations and workflow management Supervision and precepting of technicians or interns EMR/Pharmacy software proficiency (e.g., PioneerRx, Rx30, Epic) Insurance billing and prior authorization resolution Bilingual communication Professional Affiliations List any professional organizations or memberships (e.g., APhA, ASHP, OPA) Additional Professional Experience Availability & Scheduling Please Indicate Days/times You Are Available To Work Monday Morning Afternoon Evening Tuesday Morning Afternoon Evening Wednesday Morning Afternoon Evening Thursday Morning Afternoon Evening Friday Morning Afternoon Evening Saturday Morning Afternoon Evening Sunday Morning Afternoon Evening References Provide Two Professional References Name * Relationship * Phone/Email * Name * Relationship * Phone/Email * Briefly describe your motivation for joining Unity Urgent Care & Pharmacy and how your experience aligns with our mission of patient-centered care. * Applicant Certification By submitting this application, I affirm that all information provided is true and complete to the best of my knowledge. I understand that any misrepresentation or omission may result in denial or termination of employment. Signature (Typed) * Date * Upload Resume/CV Upload Resume/CV Click or drag a file to this area to upload. Choose File Thank you for your application. It has been sent. There was an error trying to send your application. Please try again later.