Access Pharmacy Resources Seminar Registration
40743 Knollwood Ct ~ Palmdale, CA 93551
661-441-0919 ~ www.accesspharmacyresources.com

Providing Designated Representative Training
and Consulting for Medical Wholesalers, Third-Party Logistics Companies and Reverse Distributors since 2002

CA/FL Designated Representative Training Webinar Registration Form
  • Name/Residence Address/Contact Information

    Use your full legal name as it appears on your Driver's License or any other legal documents.

    This information is required for the CA DR Application Training Declaration Form that we fill out for you after the class.
  • Please give us your full middle name, not just an initial. If you do not have a middle name, type in N/A.
  • MANDATORY: This is required for the CA DR Application Training Declaration that APR fills out and mails to you for you to submit with your application. We do not share your information with anyone. (If you are registering for a Florida class, please just fill this section in.)
  • - -
    If you use your cell phone as your home phone, please list the cell number here. This information is required for the CA Training Declaration.
  • - -
    This information is required for the CA Training Declaration
  • Webinar teaching materials and log-in codes are e-mailed to each class member. Please insert the e-mail address of the class attendee, even if someone else is registering for that person.
  • State/Seminar Date/Business Name and Address

  • / /
    See our Seminar Schedule page to verify the date of your class.
  • Select one class only. Separate registration is required for different state classes.
  • Pricing/Background Check/Experience Requirement

  • $ .
    Please fill in the correct amount.
  • This is needed to connect your registration with the payment if they are done by different persons.
  • Both CA and FL require a full criminal background check to obtain a license as a Designated Representative. FL does the check prior to getting approved to take the exam.

    CA has no exam, but requires each applicant attend a Board of Pharmacy approved training class. CA does the background check AFTER the class and after you submit your application.

    Access Pharmacy Resources does NOT have access to the results of this check or to any of your personal background information. Access Pharmacy Resources does not accept any liability, nor do we offer any refunds of training fees if a trainee does not pass the background check.

    Please be advised that the State of California may deny any applicant a Designated Representative permit if there is any criminal background in your past. If you have any questions in this area, you are welcome to call our office to ask, but the ultimate decision in these matters are made by the Board. Therefore, we also advise you to contact the California Board of Pharmacy.
  • If your experience does not meet these criteria, please call our office at 661-441-0919 for details and information.
  • Refund/Copyright Information

  • Cancellations: Registration fees are non-refundable for registrants who cancel 1 - 14 days before class. Registrants who cancel 15 or more days prior to class receive a 50% refund. Class may be re-scheduled without any payment penalty (see below).

    Re-Scheduling Policy: Access Pharmacy Resources, Inc. will allow any fully paid registrant to re-schedule a missed class without penalty. Registrant will be allowed to re-schedule a class within 6 months of original scheduled class date. If registrant cannot re-schedule within the 6 month allowance period, seminar registration fee may be forfeited.

    Access Pharmacy Resources, Inc. reserves the right to cancel or re-schedule a seminar and does not assume or accept any liability for having to reschedule a class for natural disasters, illness, travel abnormalities, webinar technical problems or any issue that prevents the class from being offered as scheduled.
  • All materials in this course, including but not limited to a full syllabus, class outline and all visual webinar slides, unless otherwise stated are the property of Greg Evans, Pharm.D. Copyright and other intellectual property laws protect these materials. Reproduction or retransmission of the materials, in whole or in part, in any manner, without the prior written consent of Greg Evans, Pharm.D. is a violation of copyright law.

    A single copy of the materials available through this course is made solely for instructional purposes as part of your Designated Representative training through Access Pharmacy Resources, Inc.

    BY REGISTERING FOR THIS SEMINAR, YOU AGREE TO NOT TRAIN ANY OTHER INDIVIDUALS USING ANY OF THE MATERIALS SUPPLIED TO YOU BY ACCESS PHARMACY RESOURCES, INC.

    You understand that Greg Evans, Pharm.D. is the only person who may sign a CA Designated Representative Training Declaration using the materials sent to you by him for the training class for which you are registering.

    In addition, you may not distribute such copies and/or utilize copies as "fair use" by instruction or any other means to others without prior written consent of Greg Evans, Pharm.D.

    Upon the discovery of any violation, Access Pharmacy Resources, Inc. will pursue any and all remedies available under copyright law and/or CA Pharmacy Law including the notification of said violation to all Federal and State authorities, including but not limited to the CA State Board of Pharmacy. Such a violation will be deemed by the Board to be an act involving moral turpitude, dishonesty, fraud and or deceit subjecting the licensed individual to disciplinary action up to the including suspension or revocation of his or her Designated Representative and/or drug wholesale license.
  • Image Verification
    captcha
    Please enter the text from the image:
    [Refresh Image] [What's This?]