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ACD Confidentiality agreement

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ACD Confidentiality Agreement

I, the student, agree to remove all patient identifiable information from all submitted work:

Student Name

NPA Student Number

Date

Student Signature

I, as supervising pharmacist, agree to check all course work submitted by my student to ensure there is no breach of patient confidentiality:

Pharmacist Name

GPhC Number

Date

Pharmacist Signature

If you are human, leave this field blank.

LEARN ABOUT OUR ORGANIZATIONS

LEARN ABOUT OUR ORGANIZATIONS

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