Student Agreement

Student Agreement

You must read the document available at the link below, before proceeding.

Download and read the Student Agreement

Please read carefully each of the following statements, and then check each box to confirm you understand.

1. I confirm that I will always make clear to patients that I am a student and not a qualified pharmacist or other healthcare professional, and I will not recommend treatment or suggest patients take any action that might be interpreted as medical advice. * Check box to confirm
2. I confirm that I will always display my official University Identity Badge when in contact with patients (hospital pharmacy only). I will carry my Student Card in the community pharmacy setting as a means of identification should it be requested. * Check box to confirm
3. I confirm that I understand, accept and agree to be bound by the principle of confidentiality of patient records and patient data, and also for information concerning teachers and students. I will therefore take all reasonable precautions to ensure that any personal data concerning patients, which I have learned by virtue of my position as a pharmacy student, will be kept confidential. I confirm that I will not discuss patients with other students or professionals outside the clinical setting, except anonymously. When recording data or discussing cases outside the clinical setting I will endeavour to ensure that patients cannot be identified by others. I will respect all patient records. * Check box to confirm
4. I am aware that the practice of pharmacy requires the highest standards of professional and personal conduct. I confirm that I have read, understood and accepted the Code of Conduct for Pharmacy Students and I will comply with the Code during my studies and when completing community and hospital placements. * Check box to confirm
5. I confirm that I am aware of the Fitness to Practise procedures within the School of Pharmacy and that I will be subject to these procedures if I do not abide by the Code of Conduct for Pharmacy Students. * Check box to confirm
6. I confirm that I will declare any criminal offences and other related matters, including spent or unspent convictions or cautions, to the School of Pharmacy. I am aware that this may affect my fitness to practise as a pharmacy student. * Check box to confirm
7. I confirm that I will declare any health conditions and/or disabilities to the School of Pharmacy. I am aware that poor health can affect my fitness to practice as a pharmacy student. * Check box to confirm
8. For students registered with disability services only: I hereby give my consent for the School to share my ‘reasonable adjustments’ requirements with the Clinical Placement providers. Check box to confirm
9. I confirm that I am satisfied with the indemnity arrangements between the University and my placement provider. * Check box to confirm
Student Forename(s) *
Student Surname *
Student Email *
Student Number *
Student Year of Study *
Emergency Contact Name *
Emergency Contact Address *
Emergency Contact Telephone Number *