Pharmacist &
Pharmacy Technician
Information Packet Request

If you are a pharmacist or pharmacy technician and would like to work full-time, part-time or just earn some extra money, please complete the on-line form below and we would be happy to send you an information packet. If you should have any questions or concerns, please don't hesitate to contact us.

Contact Information  
Salutation:  Mr. Mrs. Ms. Dr.
Last Name: 
First name: 
Middle initial: 
Address 1: 
Address 2: 
City: 
State:
Zip: 
Day-Time Phone:  Ext:
Evening Phone:  Ext:
FAX: 
E-Mail: 
License Type:  Pharmacist Pharmacy Technician
License Number:  State:  
NAPLEX:   Yes No
if yes, enter number:
Experience: 
(Check all that apply) 		 Retail
Hospital
LTC
Nursing Home		 Mail Order
Nuclear
Home Infusion
Managed care
Regional Preference: 
(Check all that apply) 		 California (Northern)
California (Central)
California (Southern)		 Arizona
Nevada (Northern)
Nevada (Southern)
Comments: 

I am a licensed pharmacist or pharmacy technician.

 
Pharmacy Services
Pharmacists and Pharmacy Technicians
Pharmacy Technician
Staffing

If you'd rather not send this information electronically, please feel free to print, complete and FAX it to us at: 

(818) 907-9239
Temporary

OR
short and long term
Call us at:
(818) 907-9009
(877) Rx.Rx.Rx3
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Last modified: April 20, 2005