pre-survey questionnaire and self-assessment checklist for ...

Pharmacokinetic monitoring
Consultation services: nutrition, pain, other
Target drug/disease adjustment dosing
Monitor patient outcomes of drug therapy
Patient education
Document recommendations in patient’s medical
record
DIRECTIONS: INDICATE (YES/NO/NOT
APPLICABLE) PHARMACIST PROVISION OF
THE FOLLOWING SERVICES FOR EACH
CLINIC LISTED:
Provide patient-specific drug information
Support/conduct research
Medication order-entry
Oversee drug distribution services/automated
dispensing cabinets
Drug preparation and distribution (e.g.,
chemotherapy, infusion center)
Medication administration (e.g., immunizations)
Wellness promotion programs (e.g., screenings)
Oversight of medication samples
Medication Use Evaluation participation
Participate in multidisciplinary committees
Create and implement treatment
guidelines/protocols
Clinical interventions documentation
Other services provided – Please list
Precept student clerkships
Precept resident learning experiences