Components of the Application Packet
1. Please submit eight copies of the completed application form and "Applicant's Statement," plus the following items (the original plus seven photocopies).
2. Curriculum vitae.
3. A letter of support from the chief executive officer (CEO) of the applicant’s organization confirming a commitment to establishing a service in which the pharmacist routinely provides pharmaceutical care for patients with thromboembolic conditions, and an expected implementation date.
4. A letter of support from the physician responsible for the management and support of pharmaceutical services for patients with cardiac or thromboembolic conditions.
5. Signed copy of the completed “Experiential Training Agreement”.
6. Documentation that you completed self-assessment CE tool associated with the “Improving Patient Outcomes in Thromboembolic Disorders.”