Pharmacy Candidate Questionnaire HiddenDepartment Candidate Name(Required) First Last Mobile Phone(Required)Email(Required) Band(Required)Please Select...2345678Specialty(Required)Please Select...PharmacistPharmacy AssistantPharmacy TechnicianPlease summarise your career over the last 3 years(Required)Have you ever been disciplined, suspended, or are you currently under investigation by an NHS Trust, GPHC or other employer (including other agencies) – if yes, please give details(Required)Why have you chosen to register with Total Assist? *(Required)Tell me about a recent occasion when you were under pressure and handled it successfully. - What was the situation? - What actions did you take? - What was the outcome?(Required)What is your understanding of the Medicines Act 1968?(Required)You are asked to prescribe medication which is not clearly documented within the patients notes and medical record. What should you do?(Required)What steps would you take, going forward if you become aware of an incident or complaint, which you were involved or implicated in?(Required)Please outline your understanding of Clinical Governance.(Required)Thinking about a recent difficult situation you’ve had with patient’s relatives – How did you handle this and the outcome(Required)Candidate Signature(Required)Reset to re-sign.Date of Candidate Signature(Required) DD slash MM slash YYYY Interviewer Name First Last Place of Interview Interviewers Grade/Band Interviewer SignatureReset to re-sign.Date of Interviewer Signature DD slash MM slash YYYY Did the candidate have a good command of the English language? Yes No Was the candidate pleasant and polite? Yes No Was the candidate courteous and helpful? Yes No Are you happy to offer this candidate work on the basis of this interview? Yes No NameThis field is for validation purposes and should be left unchanged.