Pharmabridge – Questionnaire Form

This form can be filled out online and submitted directly to the Coordinator by typing in the answers to the questions and clicking the submit button once finished. When completing the form, please do not use capital letters only.


1. Participation in areas described in the project:

1.1 Supply of books, CDs etc

1.2 Fellowships, faculty exchange etc

I/institution etc am/is interested in establishing a twinning relationship (for e.g. exchange of information, visits, support etc.) with an institution or an individual as follows:

1.3. Twinning arrangements

national pharmacists association
faculty of pharmacy
hospital pharmacy
drug information centre
individual pharmacist

2. Information on other ongoing schemes falling within the scope of Pharmabridge

e.g. Pharmaid as operated by the Commonwealth Pharmaceutical Association, or a fellowship scheme for pharmacists from developing countries

3. General Suggestions/Comments

4. Include Name and Email address

Yes     No