---
title: Clinical Pharmacist Application Form Template - License Verification & Residency | Paperform
description: Professional clinical pharmacist application form with license verification, residency documentation, antimicrobial stewardship experience, MTM proficiency, and interdisciplinary collaboration assessment.
url: "https://paperform.co/templates/clinical-pharmacist-application-form"
type: static
generatedAt: "2026-03-28T00:43:20.567Z"
---

[← Back to free form templates](/templates/)    ![Clinical Pharmacist Application Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/clinical-pharmacist-application-form.png)
    [Preview](https://_preview.paperform.co/ai-template/clinical-pharmacist-application-form) [Use this template for free](/create?ai-template=clinical-pharmacist-application-form)    [Application Forms](/templates/category/applications/) [Staffing & Recruitment](/templates/industry/staffing-recruitment/)[Healthcare](/templates/industry/healthcare/)[Pharmacy](/templates/industry/pharmacy/) [HR Manager](/templates/role/hr-manager/)[Recruiter](/templates/role/recruiter/)[Pharmacist](/templates/role/pharmacist/)[Healthcare Administrator](/templates/role/healthcare-admin/)     About this free form template
### Streamline Your Clinical Pharmacist Hiring with a Professional Application Form

Finding the right clinical pharmacist for your healthcare facility requires more than a standard job application. You need to verify specialized credentials, assess clinical competencies, and evaluate hands-on experience in critical areas like antimicrobial stewardship and medication therapy management. That's where this **Clinical Pharmacist Application Form** template from Paperform comes in.

#### Why Healthcare Organizations Choose This Template

Whether you're a hospital system, specialty clinic, long-term care facility, or retail pharmacy expanding into clinical services, this form template is designed specifically for the rigorous requirements of clinical pharmacist recruitment. It goes beyond basic employment screening to capture the nuanced qualifications that distinguish exceptional clinical practitioners.

**Key features of this template include:**

 - **License verification fields** that collect pharmacy license numbers, state of licensure, expiration dates, and Board Certification status (BCPS, BCACP, etc.)
 - **Residency completion documentation** sections for PGY1 and PGY2 programs, including program names, dates, and focus areas
 - **Antimicrobial stewardship experience** assessment covering protocols, interventions, audit participation, and outcomes
 - **Medication therapy management (MTM) proficiency** evaluation including disease state management expertise
 - **Interdisciplinary rounding participation** documentation to assess collaborative practice experience
 - **Clinical rotations and specialty experience** capture for critical care, oncology, cardiology, and other focus areas

#### Built for Healthcare Hiring Workflows

This form integrates seamlessly into your existing recruitment process. Applicants can upload their CV, pharmacy license, board certifications, letters of recommendation, and residency completion certificates—all in one organized submission. No more chasing down documents via email or managing messy file attachments.

The conditional logic built into this template ensures applicants only see relevant follow-up questions. For example, if someone indicates they've completed a PGY2 residency, additional fields appear asking about their specialty focus and preceptor information. This creates a cleaner experience while capturing all the details you need for credentialing and evaluation.

#### Perfect for Healthcare HR Teams and Pharmacy Directors

**Hospital pharmacy directors** use this form to quickly identify candidates with specific clinical competencies—whether that's critical care experience, antimicrobial stewardship expertise, or a particular board certification.

**Healthcare HR departments** appreciate the structured format that makes applicant comparison straightforward and ensures consistent documentation for compliance purposes.

**Specialty pharmacies and clinics** leverage this template to find pharmacists with MTM experience and disease state management skills that align with their patient populations.

#### Automate Your Hiring Pipeline with Stepper

Once an application is submitted, you can use [Stepper](https://stepper.io)—Paperform's AI-native workflow builder—to automate what happens next. Set up workflows that:

 - Send automatic acknowledgment emails to applicants
 - Notify your hiring committee when qualified candidates apply
 - Create tasks in your project management tools for screening calls
 - Update your applicant tracking system (ATS) with new submissions
 - Flag applications that meet specific criteria (e.g., board certified + residency completed)
 - Route different specialty applications to the appropriate department heads

This eliminates manual data entry and ensures no qualified candidate falls through the cracks during busy hiring periods.

#### Designed for Compliance and Professionalism

In healthcare hiring, compliance matters. This form template helps you maintain organized records for credentialing, privileging, and regulatory requirements. All submissions are securely stored and can be exported for verification purposes or integration with your HR systems.

The professional design reflects well on your organization, presenting a polished first impression to top-tier clinical pharmacist candidates who expect a modern, streamlined application experience.

#### Integrations That Work with Your Stack

Connect this form to the tools your HR and pharmacy teams already use:

 - **Google Sheets or Airtable** for applicant tracking spreadsheets
 - **Slack or Microsoft Teams** for instant hiring team notifications
 - **HubSpot or other CRMs** to manage candidate relationships
 - **Email marketing tools** to nurture your talent pipeline
 - **ATS platforms** via Stepper, Zapier, or webhooks

#### Customization Made Simple

While this template is ready to use immediately, Paperform's document-style editor makes customization effortless. Add your hospital logo, adjust the color scheme to match your brand, include additional questions about specific clinical programs at your facility, or modify the language to reflect your organization's culture—all without touching a line of code.

Need to add questions about specific EHR systems your facility uses? Want to include behavioral interview questions? It takes just minutes to tailor this form to your exact hiring needs.

#### Trusted by Healthcare Organizations

Paperform is SOC 2 Type II compliant and offers the security and reliability healthcare organizations require. Over 500,000 teams worldwide trust Paperform for sensitive workflows, from patient intake to employment applications.

Whether you're filling a single clinical pharmacist position or building out an entire department, this template helps you identify the best candidates efficiently while maintaining the rigorous standards healthcare hiring demands.

**Get started today** and transform your clinical pharmacist recruitment from a paper-heavy, disorganized process into a smooth, professional experience that attracts top talent.
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