Pharmacy Technician Evaluation (NWC)

Please mark the following statements with the most appropriate values. These values show the extent to which you believe your assistant has shown their level of dedication.

  • (Please enter the first and last name of your assistant, ex. John Smith)
  • (Please enter the number of total days attended, ex. 30)
  • (Please enter the number days absent, ex. 2)
  • (Please enter the number of days tardy, ex. 1)
  • (PLEASE NOTE: A total of 280 hours is required.)

  • Practical Experience In:

  • Unit Dose Dispensing:

  • Knowledge of Prepackaging & Compounding:

  • Preparation of IV Admixtures:

  • Label Typing Skills:

  • Use of Patient Profiles:

  • Controlled Substances:

  • Knowledge of Ordering/Billing Procedures:

  • Personal Traits & Appearance:

  • (If you have any other comments please leave them in this box)
  • (Please enter the name of your hospital or pharmacy)
  • (Please enter your name, ex. Dr. James Brown)
  • (Please enter your e-mail address)
  • - -
    (Please enter your telephone number)