Host a Training

If you wish to host a NASPA Pharmacy-Based Point of Care Test & Treat National Certificate Program, please complete the form below.

All forms must be submitted to NASPA at least 4 weeks prior to your scheduled training. Please email education@naspa.us with any questions.

Training Information
Registered Provider Name*
If you are not a current Pharmacy-Based Point-of-Care Test & Treat National Certificate Program Registered Provider, please contact education@naspa.us.
Date of Training*
MM slash DD slash YYYY
Tentative Time of Live/Virtual Session
Location of Training*
Anticipated Number of Pharmacist Participants
Anticipated Number of Pharmacy Technician Participants
Anticipated Number of Student Participants
Training Coordinator
Training Coordinator Name*
First Last
Training Coordinator Email*
Training Coordinator Phone*
Training Faculty
Number of Trainers*
- One
- Two
- Three
Faculty Name*
Faculty Email*
Faculty CV*
Max. file size: 1 MB.
Signed Faculty Agreement*
Max. file size: 1 MB.
Additional Faculty Name*
Additional Faculty Email*
Additional Faculty CV*
Max. file size: 1 MB.
Additional Signed Faculty Agreement*
Max. file size: 1 MB.
Additional Faculty Name*
Additional Faculty Email*
Additional Faculty CV*
Max. file size: 1 MB.
Additional Signed Faculty Agreement*
Max. file size: 1 MB.
Program Listing
Do you wish to list your upcoming program on our website for those seeking to take the program?*
- Yes
- No
Please list the website URL or email address that you want interested participants to use to register for the program.*

Additional Information