Ohio Admin. Code 4729:2-2-06 - Statement of preceptor and practical experience affidavit
(A) At the
beginning of internship, or if there is a change in preceptor or employment
site, the intern must submit a completed statement of preceptor form within
thirty days of the change to the state board of pharmacy. The filing of a
statement of preceptor form is not required for a change of preceptor or
internship site related to a school of pharmacy academic program.
(B) The intern is responsible for submitting
the following required forms to certify the hour and supervision requirements
pursuant to rule
4729:2-2-05 of the
Administrative Code:
(1) A statement of
preceptor form must be received by the state board of pharmacy for each
pharmacy intern within thirty days of beginning an internship under a
preceptor's supervision.
(a) No credit will be
given for practical experience obtained prior to thirty days of the date that
the statement of preceptor form is received by the board office; except, in the
event of extraordinary circumstances and when due to no fault of the intern,
the board may accept a retroactive date of filing for the statement of
preceptor.
(b) The intern must file
a statement of preceptor form whenever the intern changes internship sites
and/or preceptors. The form must be submitted within thirty days of a change of
internship site and/or preceptor.
(2)
A practical
experience affidavit form shall be used to submit evidence of practical
experience for internship credit earned outside of the intern's school of
pharmacy academic programA practical
experience affidavit form must be used to submit evidence of practical
experience for internship credit.
(a)
Practical experience reported on the affidavit shall be the total number of
actual clock hours worked during the reported time period rounded to the
nearest hour. The hours reported must be able to be documented by payroll or
other records which may be examined by the state board of pharmacy upon
request.
(b) Practical experience
affidavits must be signed by the preceptor and submitted to the state board of
pharmacy. In the event of the unavailability of the preceptor's signature due
to extraordinary circumstances and due to no fault of the intern, the board may
accept an alternative method for verification of a practical experience
affidavit.
(c)
Practical experience affidavits for a calendar year may
be submitted at any time, except that they must be submitted to the board no
later than one year after the credit is earned.
(c) Practical experience affidavits
for a calendar year may be submitted at any time, except that they must be
received in the board office or postmarked no later than the first day of March
of the following year.
(d) No internship credit shall be granted by
the board for practical experience obtained before licensure as an intern or
during a period when the intern's license has lapsed.
(C) Statement of preceptor and
practical experience affidavit forms may also be used to document any
additional hours completed by the intern.
Notes
Promulgated Under: 119.03
Statutory Authority: 4729.26
Rule Amplifies: 4729.08, 4729.11
Prior Effective Dates: 06/01/1972, 09/10/1976, 02/15/1982, 03/19/1987, 07/01/1990, 07/01/1992, 07/01/1994, 01/17/1997, 02/01/2002, 02/01/2003, 02/01/2005, 01/01/2006, 04/27/2007, 09/15/2017
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