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Create New Registration · Customer Self-Service
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Create New Registration
Create New Registration
Step 1
Step 2
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Step 4
Step 5
Step 6
End-User Information
End-User Name (Company Name)
*
*
Type of Organisation
*
Retail Pharmacy Business (Community Pharmacy)
Wholesaler
Hospital Pharmacy Registered as Retail Pharmacy Business
Hospital
Other
If 'Other' was selected for 'Type of Organisation', provide details
*