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Terms & Conditions

Client Registration

Pharmacy Name*

Contact Name and Position:*

Pharmacy Address*

Pharmacy Phone & Contact Mobile:*

Email Address(s) - Contact & Billing*

Dispensary System, POS System and Average number of scripts per day:*

Pharmacy Hours:*

Single choice

Do you have a Dispensary Technician?

Is your pharmacy responsible for a Methadone Programme?

Is your pharmacy responsible for a Nursing Home or Special Care Facility?

Any further information relevant to your pharmacy AND/OR dates you would like to arrange cover for:

Have you read our Terms and Conditions? Completion of this registration indicates acceptance of all terms and conditions.

Terms and Conditions

Therese Brownhill

therese.pharmatemp@gmail.com

Kym Bircham

0407 884949

kym.pharmatemp@gmail.com

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