Healthcare Professional

Are you a Private Doctor or Dentist?

Would you like to offer your patients with a delivery service for their prescriptions?

How it Works

Once approved you can write prescriptions directly on our platform.

Once we receive the prescriptions we quote you or the patient directly.

The patient pays for their prescription and we deliver directly to them.

How does this benefit you

You can offer an all in one solution to your patients
All of our prices are competitive, helping to build patient confidence
Our platform is really easy to use and maintains an up to date digital record for your reference
The platform can be used as a marketing tool to your patients
The platform can help you to continue your service even if the patient is unable to come and visit you for an appointment

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Who's filling out this form?

Full Name *:

What type of medical professional are you? *

Doctor Dentist Nurse Pharmacist Other

Please Specify *:

Phone *:

Company *:

If sole trader please write "sole trader"

Email *:

Password *:

Confirm Password *:

How many surgeries/premises would you like to add to the service

Number of Surgeries/Premises *:

Location 1

Premises/Surgery Name *:

Address *:

Surgery Postcode *:

Telephone number *:

Premises Email *:

Professional Register number *:

How many prescribers would you like to add to the above surgeries at this time?

You can add more later Depending on answer it opens up multiples of the follwing fields

Number of Prescribers *:

Prescriber 1

Add Myself as prescriber

(We require a legible written or generated signature that can be used on generated prescriptions written by you)

This prescriber will be sent a secure link via email to complete their account set up. This will entain them agreeing to our terms of service and providing a legible written or generated signature thatcan be used on their generated prescriptions.

Full Name *:

What type of prescriber are you? *

Please Specify *:

Professional Register Number *

Contact Telephone *:

Personal Email *:

Which surgeries will they be workng in? *:

Please Upload a Valid Photo ID *:

Prescriber 2

Add Myself as prescriber

(We require a legible written or generated signature that can be used on generated prescriptions written by you)

Full Name:

What type of prescriber are you?

Please Specify:

Professional Register Number

Contact Telephone:

Personal Email:

Which surgeries will they be workng in?:

Please Upload a Valid Photo ID *:

Prescriber 3

Add Myself as prescriber

(We require a legible written or generated signature that can be used on generated prescriptions written by you)

Full Name:

What type of prescriber are you?

Please Specify:

Professional Register Number

Contact Telephone:

Personal Email:

Please Upload a Valid Photo ID *:

Which surgeries will they be workng in?:

Prescriber 4

Add Myself as prescriber

(We require a legible written or generated signature that can be used on generated prescriptions written by you)

Full Name:

What type of prescriber are you?

Please Specify:

Professional Register Number

Contact Telephone:

Personal Email:

Which surgeries will they be workng in?:

Please Upload a Valid Photo ID *:

Prescriber 5

Add Myself as prescriber

(We require a legible written or generated signature that can be used on generated prescriptions written by you)

Full Name:

What type of prescriber are you?

Please Specify:

Professional Register Number

Contact Telephone:

Personal Email:

Which surgeries will they be workng in?:

Please Upload a Valid Photo ID *:

Are you a Private Doctor or Dentist?

Would you like to offer your patients with a delivery service for their prescriptions?

How it Works

How does this benefit you

Section 1

Who's filling out this form?

Section 2 - Premises/ Surgery Details

How many surgeries/premises would you like to add to the service

Location 1

Section 3 - Prescriber Details

How many prescribers would you like to add to the above surgeries at this time?

Prescriber 1

Prescriber 2

Prescriber 3

Prescriber 4

Prescriber 5