EMPoweRx 2024 Clinical Skills Competition Registration Form

The EMPoweRx Clinical Skills Competition is an exhilarating event where pharmacy residents, medical residents, and PA/NP Fellows, EMTs, and other practitioners within 3 years of graduation come together to display their clinical acumen in emergency medicine pharmacotherapy. Teams of up to two members will compete in multiple virtual rounds with a live championship round held during the EMPoweRx Conference on April 26-27, 2024, at Hilton's Embassy Suites Arysley, Charlotte, NC. Registration Details: Registration Period: October 18, 2023 - December 31, 2023 Event Dates: Week preceding April 26-27, 2024 (Virtual Rounds), Live Championship Round on April 26-27, 2024. Platform for Virtual Rounds: Pharmacy & Acute Care University (PACU) via the PACUPrep Platform (pharmacy-acute.synap.ac)

Team Name *

Please enter a creative team name for identification.

Team Member 1: *

First

Last

Team Member 1 Credentials:

Team Member 1 Affiliation:

Team Member 1 Email Address:

Team Member 1 Contact Number

Team Member 2 Name

First

Last

(Optional)

Team Member 2 Credentials:

(Optional):

Team Member 2 Affiliation:

(Optional):

Team Member 2 Email Address:

(Optional):

Team Member 2 Contact Number

(Optional):

I agree to abide by the rules and guidelines set forth for the EMPoweRx 2024 Clinical Skills Competition.

Please specify if any special accommodations are required for any team member during the virtual or live rounds.

Submission:

By submitting this form, you confirm the accuracy of the information provided and agree to the terms and conditions of the EMPoweRx 2024 Clinical Skills Competition.

CV Upload For Team Member 1

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CV Upload For Team Member 2

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