University
Health Services
Student PHARMACY
Volunteer Program
Information
for
FALL 2012
_______________________________________________________________________________________
PLEASE READ CAREFULLY
The University Health Services (UHS) Student Pharmacy Volunteer Program provides students with the opportunity to
be introduced to the pharmacy profession and exposed to the dynamics of a clinic pharmacy serving students in a
university setting. Student volunteers are utilized in a clerical capacity for FOUR hour shifts each week during the
semester. NOTE: All UHS Pharmacy volunteers must have specific health clearances and a background check with
UCPD before they start working at the pharmacy. Please see the following pages for more information.
Important Dates
Saturday, August 18th, 12 noon
Web based application due. Please use link provided below
which includes your resume, and personal statement.
https://docs.google.com/spreadsheet/viewform?fromEmail=true&formkey=dDRFM0xBZThCTDFTdWtRNTZPMmZtOVE6MA
August 22nd – 29th
August 30th , 12AM midnight
September 1st, 5PM
TBA, week of September 3rd
Week of September 17th(as soon
clearance is received)
Thru Week of December 3rd
Interviews if needed
Selection Notifications via email
Email Acceptance/Confirmation from selected volunteers
Training and Background Checks
Volunteering Beginning (depending on Background Check
processing) / End Dates
How are applicants chosen?
 Students are selected based on their interests, goals, compatibility, and availability.
 Personal Statement stating:
o Objectives/goals for the volunteer program
o Projected career path/choice and rationale for the selection
o Short – term goals (1-2 years)
o Long – term goals (5-10 years)
 Interviews, time permitting – in person, or by phone.
 Returning volunteers have priority, but no guarantees.
What can applicants expect?
 Students should be proactive in advancing their knowledge in the field of pharmacy by interacting with pharmacists,
technicians, and staff.
 To gain knowledge regarding opportunities in the field of pharmacy, pharmacy rules and regulations, issues surrounding
the field, and the past, present, and future of pharmacy.
 On – the – job experience and observations working with pharmacy personnel and patients:
o Pharmacy workflow/logistics.
o Roles of pharmacy personnel (i.e. Clerks, Technicians, Pharmacists, Volunteer).
o Pharmacy Benefit Management (limited to SHIP) and Drug Education.
 An opportunity to contribute to the UHS and the UCB community.
What is expected of student applicants?
 Enthusiasm, Commitment, and Dedication.
 Commit to a 4 hour weekly shift for the entire semester. Weekly attendance is highly expected.
 Adhere to the attendance policies of the pharmacy program. Failure to follow the policies will result in the immediate
forfeiture of the position. Informing the coordinator of any absences in advance of scheduled shift.
 Keep student/staff medical information confidential as set by the Statement of Confidentiality, and your supervisor.
Failure to do so could result in loss of position and prosecution within the court system. Confidentiality forms are signed
and returned by the designated date. Copies are kept on file for five years.
For more information on this program, contact UHS Pharmacy 642-3249, or Pharmacy@berkeley.edu
University Health Services Volunteer Program
HEALTH CEARANCE GUIDELINES*
HEALTH CLEARANCE – Required Immunizations shown below:
Provide a COPY of your IMMUNIZATION RECORD
(This must be signed by a health care provider and
include their office stamp)
OR
If you are unsure about your immunization status
or don’t have records, have your immunity checked
or immunizations done at UHS for a fee. These may
be obtained at the Allergy/Travel Clinic or other
healthcare provider.
YEARLY
Proof of
Immunity
You need to satisfy ONE of the options for EACH condition
Option 1
Influenza
TB Clearance Don't test until
notified.
Negative TB skin test
Option 2
1 documented dose from
current year
Negative T-spot or
Quantiferon test
(cannot expire within
volunteering period)
Admin Check
(UHS USE ONLY)
Option 3
Cost at UHS:
Positive TB skin
test with negative
chest x-ray &
symptom review.
with SHIP- $5
w/out SHIP-$25-30
Must have negative result
before placement.
NO COST to selected
volunteers.
EVERY 10 YEARS
Tdap
Option 1
Cost at UHS:
1 dose of Tdap
vaccine
with SHIP- $12
w/out SHIP-$60
ONE-TIME
You need to satisfy ONE of the options for EACH condition
Option 1
Option 2
Option 3
Measles
(Rubeola)
Mumps
Born before 1957
Born before 1957
Rubella
(German Measles)
Varicella
(Chicken Pox)
History of Chicken
pox or Herpes Zoster
documented by a
healthcare provider
2 documented doses of
measles vaccine
2 documented doses of
mumps vaccine
1 documented dose of
Rubella vaccine or MMR
(Measles/Mumps/Rubella)
2 documented doses of
Varicella Vaccine
Positive titer for
measles
Positive titer for
mumps
Positive titer for
mumps
Positive titer to
Varicella
Cost at UHS:
with SHIP-$3.40
w/out SHIP-$17
with SHIP- $21
w/out SHIP-$105
Medical questions? Call a UHS Clinic Advice Nurse at 510-643-7197 or Check our website: www.uhs.berkeley.edu
*Your health clearance should be complete As Soon As Possible - no later than the first day of
Pharmacy volunteering. NO EXCEPTIONS! Plan for delays and scheduling! Incomplete health
clearances may result in forfeiture of your position. Keep all your original records, you will need to
provide them if you volunteer in the future!
For more information on this program, contact UHS Pharmacy 642-3249, or Pharmacy@berkeley.edu
UHS Pharmacy Volunteer Program
HEALTH CLEARANCE FORM – FALL 2012
Submit ONLY after you have been notified
(not needed for initial application)
Last Name:
First Name:
Date of Birth:
Contact Phone:
SID#
Major/Year in School:
HEALTH CLEARANCE (to be completed by clinician--or you may attach documentation on a separate
sheet, Due ASAP, or no later than the first day of volunteering)
TUBERCULOSIS (TB) TESTING
TEST

PPD
STRENGTH
DATE GIVEN
DATE READ
5 TU
_________
_________
RESULTS
_____MM INDURATION
 INTERMED
IF CHEST X-RAY DONE: DATE___________
READING___________
HISTORY OF INH
PROPHYLAXIS_________________________________________________________________
______________________________________________________
CLINICIAN SIGNATURE/TITLE (PLEASE USE OFFICE STAMP)
DATE
OTHER MEDICAL CLEARANCE DOCUMENTATION
DATE(S) GIVEN
MMR ______________________
(measles, mumps, rubella)
TDAP _________________
DATE(S) GIVEN
MR ______________________
VARICELLA __________________
INFLUENZA ________________
_____________________________________________________________________
CLINICIAN SIGNATURE/TITLE (PLEASE USE OFFICE STAMP)
DATE
For more information on this program, contact UHS Pharmacy 642-3249, or Pharmacy@berkeley.edu