Tennessee Pharmacists Association | TPA Member Champions

A lot of TPA members go above and beyond the call of duty every single day to make a difference in patients' lives. They don't ask for anything in return, and their dedication might not be obvious to anyone except their patients and those who are privileged to have worked with them.

TPA would like to shine a light on your extraordinary dedication to patients and your profession. Please answer a few brief questions below. And if you have any questions, please contact Julie Schuffman at the TPA office: julie@tnpharm.org or 615-256-3023.

Thank you very much!

* = Required Field

The easy questions...

NAME AND CREDENTIALS:*

Please enter your name, followed by your degree and any other credentials that should appear after your name.

EMAIL ADDRESS:

PHONE NUMBER:

Phone Type:

Is the phone number above a cell phone, work phone, or home phone? (Check all that apply.)

Cell Phone
Home Phone
Work Phone

PLACE OF BUSINESS:

YOUR POSITION:

Please indicate your role(s) with the Place of Business listed above. (If you select "Other" below, a field for entering your role(s) will appear.)

Other role(s):

LOCATION OF YOUR PLACE OF BUSINESS:

City State

HOW LONG HAVE YOU BEEN IN PRACTICE?

These questions take a little more thought....

Please answer as many as you like!

1. YOUR BACKGROUND

What is your pharmacy background?

2. YOUR PHILOSOPHY

What is your philosophy about patient care?

3. YOUR MENTORS

Who have been some of your most influential mentors?

4. YOUR MOTIVATION

Can you explain what you love about being a pharmacist? And/or, please describe one or more of your patient "success stories" that made you think, "THIS is why I love being a pharmacist."

5. YOUR ONE WISH

If you could make one wish come true for pharmacy practice, what would it be?

ADDITIONAL INFORMATION, COMMENTS, OR QUESTIONS:

PHOTO(S):*

Please upload a photo of yourself and/or your pharmacy team. The maximum for each file is 2 MB.

Drop files here or

Max. file size: 256 MB.