Online Form_PT register of toxicologists

Full Name*

PrefixFirst NameMiddle NameLast Name

Date of birth*

DayMonthYear

VAT number

Gender*

MaleFemale

Home address*

Street Address

Street Address Line 2

City

Postal / Zip CodeCountry

Work address*

Street Address

Street Address Line 2

City

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

E-mail*

Employer*

Job position*

How long have you worked in the field of toxicology?*

Please send all correspondence to:*

Home addressWork addressE-mail address

I am a member of:*

SPFAP ToxNone

Academic Education completed:*

Degree Level (i.e. Master)

Field of Study

University Name

Date of completionCountry

Degree Level (i.e. Master)

Field of Study

University Name

Date of completionCountry

Degree Level (i.e. Master)

Field of Study

University Name

Date of completionCountry

Degree Level (i.e. Master)

Field of Study

University Name

Date of completionCountry

Degree Level (i.e. Master)

Field of Study

University Name

Date of completionCountry

Copy of all certificates MUST be sent with the application. Only certificates with text in Portuguese and English will be accepted. Please ensure an official translation if required.

I hereby apply for registration as a registered toxicologist on the basis of:*

Route 1: Attendance of appropriate courseRoute 2: Practical experience and on the job trainingRe-registration

Recommendation Letters

Please list the names and other relevant information regarding the two expert reviewers that support your application. (please note that the expert reviewer’s opinion letter must be submitted with the application).

Expert Reviewer Name

Relevant Information

i.e. when did you work with this expert, is the expert ERT...

Expert Reviewer Name

Relevant Information

i.e. when did you work with this expert, is the expert ERT...

Route 1 Applications

Applicants are to complete all parts of part A and at least two from part B. Copy of all certificates MUST be sent with the application. Only certificates with text in Portuguese and English will be accepted. Please ensure an official translation if required.

PART A: COMPULSORY/MANDATORY TOPICS

Topic/Course Name*

	Date	Information
1. Principles of Toxicology
2. Laboratory Animal Science incl. 3 R
3. Experimental Design and Statistics
4. Molecular and Cellular Toxicology
5. Absorption, Distribution, Metabolism and Excretion
6. Organ Toxicology and Histopathology
7. Toxicology of Environmental Pollutants
8. Exposure Assessment
9. Epidemiology
10. Occupational Toxicology
11. Genotoxicity and Carcinogenicity
12. Reproductive and Developmental Toxicology
13. Risk Assessment of Chemicals
14. Clinical and Forensic Toxicology

PART B: OPTIONAL TOPICS

Topic/Course Name*

	Date	Information
15. Drug Safety Assessment
16. Regulatory Toxicology
17. Ecotoxicology
18. Nanomaterials
19. In vitro Testing Methods
20. In silico Toxicology
21. Immunotoxicology
22. Neurotoxicology
23. Analytical Methods in Toxicology

Route 2 Applications

Applicants are to provide evidence of experience in one of the fields of toxicology acquired by long-standing experience and on the job training. Evidence is documented by:

* Only documents with text in Portuguese and English will be accepted. Please ensure an official translation if required.

Topic Name*

	Select at least two topics (yes or no)
C1. Post-mortem methods, animal or human pathology and histology. Microscopic recognition of the major pathological processes. Foetal and neonatal examination for malformations.
C2. Making observations and records of signs in animals or humans. Humane dosing, sampling and euthanasia of animals; in vivo monitoring, biomonitoring, biomarker studies on animals or humans. Prevention, diagnosis and treatment of acute or chronic chemical exposure and poisoning.
C3. Principles and techniques of cell culture. Testing for compound effects on cells in culture, including applied methodology such as the Ames Test; recognition of basic chromosomal aberrations, blood film analysis, subcellular fractionation techniques.
C4. Computer-aided technologies in toxicology. (Quantitative) structure-activity relationships, read-across, calculations of toxicity and biokinetics/dynamics (PBPK/TD) and computational structural biology.
C5. Standard analytical methods and techniques, e.g. spectrophotometry, gas and high performance liquid chromatography, mass spectrometry; biochemical and molecular techniques: e.g. protein determination, enzyme activity, blotting and antibody-based techniques, radiochemistry, Reverse-transcriptase (RT) and Real time (RT)-polymerase chain reaction (PCR), “omics” techniques.
C6. Design of experiments, biometric and statistical procedures. Data retrieval, data derivation, computer-assisted technologies, data-bases, data-banks, and data acquisition.
C7. Determination of pharmacokinetic parameters and compound metabolism.
C8. Procedures in risk analysis (risk assessment, management and communication), regulatory toxicology, data reliability and relevance, risk-assessment experience under mentorship.

Documented Evidence*

	Information
1.Peer‐reviewed publications
2. Confidential reports
3. Assessments
4. Teaching activities
5. Advisory activities
6. Other achievements

File Upload

Academic certificate*

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Course certificate*

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List of Publications and other supporting docs*

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Motivation Letter*

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(2-page limit)

Detailed CV*

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(4-page limit)

Recommendation letter*

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2 letters

Registration fee payment proof*

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Sociedade Portuguesa de Farmacologia / IBANPT50 0035 2021 00043183930 30 / BIC SWIFTCGDIPTPL

Observation

CHECKLIST*

A completed application formCopy of all academic certificatesCopy of all courses supporting your applicationList of publications and other documentation supporting your expertise in toxicologyA motivation letter (2-page limit) in englishA detailed CV (4-page limit) in englishTwo recommendation letters in englishRegistration fees payment proof

Date*

DayMonthYear

APPLICATION FOR REGISTRATION AS TOXICOLOGIST in the Portuguese Register of Toxicologists

Registration Form