Applicant Certification Agreement
All applicants must agree to the following Applicant Certification Agreement and to all policies and procedures and the terms and conditions of the Pharmacy Benefit Management Technician Certification Program prior to being accepted as a candidate.
I hereby apply to become certified as a Pharmacy Benefit Management Certified Technician. I have received a copy of the Pharmacy Benefit Management Technician Certification Program (Program) Candidate Handbook, have read it, understand it and agree to be bound by it and all policies and procedures of the Program. I will review and accept updates and amendments to the Program’s policies and procedures as they are amended including, without limitation, those posted on the Program’s website: www.pbmct.com.
I certify that I meet all of the eligibility requirements to become a candidate for certification and I that the information contained in this application has been completed in good faith and is true and complete. I understand that the Program may require additional information and I agree to supply this information if/ when requested. I authorize the Program to contact any organization or person it deems necessary to verify the information I have provided with my application. All materials supplied to the Program, become property of the Program once submitted with my application. I understand that if it is later proven that I do not meet the requirement for certification, my application fee will not be refunded.
I certify that I will act in a way that is consistent with the Program’s Code of Conduct and other applicable Program policies. I will report to the Program, any charge, complaint or ethics-related matters in which I am implicated within 30 days of the date of the occurrence. I agree to maintain the confidentiality of all examination materials and agree not to disclose, publish, reproduce, or distribute examination information. I agree to cooperate with any subsequent investigation regarding such matters. I understand that if any information provided by me is later deemed to be false, the Program reserves the right to revoke my certification. I agree to comply with all disciplinary or corrective action decisions of the Program, including suspension or revocation of my certification. If my certification is suspended or revoked, I agree to cease use of the PBMCT certification designation immediately. If appeal of an adverse decision is pursued, per the Policy and Procedures of the Program, I agree to cease use of the PBMCT certification until such time as the Program’s Board of Directors has determined the outcome of this appeal.
I understand that the Program and contracted Program vendors may collect, transmit, transfer, use, save, deliver and otherwise process candidate information for analysis, marketing, or other purpose deemed necessary to operate the Program. I hereby authorize the Program to disclose and share my name as well as any other basic demographic information required to help verify my certification status.
I agree to register on the examination site and sign up for an examination location, date and time. I will bring my candidate approval email to the testing center and I will provide a government issued form of identification which exactly matches the name on my candidate approval email. I will complete the accommodation request form if I need special examination accommodation. I agree to act responsibly and with integrity in taking the examination. I understand that if I fail to appear on my scheduled date, time and location take the examination my application fee will be forfeited.
I hereby release, discharge, and exonerate the Program, its directors, officers, members, employees, representatives, agents and parent company(ies) from any and all actions, suits (including third-party suites), complaints, losses or damages, liability claims or demands, including attorney fees, arising out of, or related to any aspect of the certification process including examination results or any other decision that may result in a decision to not issue me a certification, or related to my certification, my use of and display of my certification or references to the Program, my activities and services. I understand that the PBMCT Certification does not represent licensure or work authorization.