Tel: 01275 462451
Fax: 01275 462935
Client Registration

To Register as a Client please provide the following information and confirm that you have read and accept the terms and conditions as outlined below.

Fields marked with a Asterisk are mandatory

Pharmacy Name*
Contact Name*
Email Address*
Address*

Town*
Post Code*
Telephone Number*
Hours of Business*
Hourly Rate*
Travel Rate Paid*
Computer System(s)*

To complete the registration procedure please tick the box below if you have read and agree to be bound by the terms and conditions outlined above.

I confirm that I understand the terms of this agreement and I agree to be bound by the conditions herein.


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