Pacific University School of Pharmacy 2015-2016
Advanced Pharmacy Practice Experience (APPE)
sopexperiential@pacificu.edu or FAX (503) 352-7398
Contacts:
Anita Cleven (anita.cleven@pacificu.edu), Courtney Kraus (courtney.kraus@pacificu.edu)
Nora Garfias (nora.garfias@pacificu.edu), Rose Dahl (rdahl@pacificu.edu)
Name of Facility:
Primary Preceptor/Coordinator:
Facility Address/City/State/Zip:
Preceptor Phone:

_
_
_Email:
Please check the box below that best describes the experience your site offers. For multiple rotation types, complete one
sheet per rotation type (i.e. one sheet for Health System rotations, a second sheet for Internal Gen Med rotations, etc.) For
assistance planning multiple rotations please contact the Experiential Team.
Required/Core Student Coursework
 Advanced Community Pharmacy
 Health System/Institutional
 Ambulatory Care
 Internal General Medicine
Elective Student Coursework (Elective Description)
 Patient Care Elective
 Non-Patient Care Elective
APPE
APPE/IPPE
APPE
APPE
APPE
APPE
APPE
APPE
5/11/156/19/15
*IPPE- P2*
8/3/159/11/15
9/14/1510/23/15
10/26/1512/4/15
12/28/152/5/16
2/8/163/18/16
3/21/164/29/16
Circle
Number of
Students:
Circle Number
of Students:
Circle Number
of Students:
Circle Number
of Students:
Circle Number
of Students:
Circle Number
of Students:
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
Other #
Other #
Other #
Other #
Other #
6/22/157/31/15
Circle Number of
Students:
Circle Number of
Students:
1 2 3 4
1 2 3 4
1 2 3 4
Other #
Other #
Other #
Introductory Health System Pharmacy Practice
Experience (IPPE-P2)
**6 weeks at 40 hours per week**
6/22/15-7/31/15
(Same date as Pacific’s second APPE Block)
Circle Number of IPPE students
2 3 4
Other #
_