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

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Other:<br />

DIRECTIONS: INDICATE<br />

(YES/NO) PHARMACIST<br />

PROVISION OF THE<br />

FOLLOWING SERVICES FOR<br />

PATIENT CARE AREAS<br />

LISTED:<br />

Provide patient-specific drug<br />

in<strong>for</strong>mation<br />

Participation in medical<br />

emergencies<br />

Clinical outcomes documentation<br />

Patient education <strong>and</strong> discharge<br />

counseling<br />

Support/conduct research<br />

Participate in multidisciplinary<br />

rounds<br />

Medication Use Evaluation<br />

participation<br />

Create <strong>and</strong> implement treatment<br />

guidelines/protocols<br />

Participate in multidisciplinary<br />

committees<br />

Clinical interventions<br />

documentation<br />

Other services provided – please<br />

list:<br />

Precept student clerkships<br />

Precept resident learning<br />

experiences

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