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* 1. In which province or territory are you located?

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* 2. Please select your primary place of work

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* 3. Does your facility compound hazardous drugs?

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* 4. Please indicate the number of compounded sterile doses per day at your facility?

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* 5. What is your current job title?

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* 6. Please indicate any professional designations you hold.

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* 7. How long have you been practicing?

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* 8. Please indicate which of the following apply to your current role. Check all that apply

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* 9. Does your current facility use a closed system transfer device?

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* 10. Does your current facility perform surface wipe testing?

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* 11. If selected to attend you will be asked to complete the following, please indicate your agreement.
  • Supply a current, signed copy of your resume
  • Sign an agreement with BD
  • Complete forms to receive payment for honorarium via direct deposit.

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* 12. To participate in this event you will need a device with video capabilities.  Please indicate what type of device you use to attend the event.

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* 13. Please provide your contact information.

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