Preceptor Training - School of Pharmacy

Please complete a separate registration form for each individual attending. Once we receive your registration, you will receive a confirmation with the Conference Zoom Information.

If you have any questions about registration, please call 757-728-6791.

Title

First Name

Last Name

Company/Employer

Position and Practice Type (e.g. Ambulatory Care, Internal Medicine, Community, Institutional)

Street Address

City

State

ZIP Code

Country

Phone Number

Graduating Pharmacy School

Year Graduated