Apply for Trade Account – MyPharmacyBags

Pharmacy Account Opening Form

Complete your pharmacy details below. All applications are reviewed within 24 hours and are subject to our Terms and Conditions of Trade.

1. Pharmacy Details

Pharmacy Name *

Business Type *

Trading Address *

City *

Postcode *

Telephone *

Email Address *

Superintendent Pharmacist Name *

GPhC Registration Number *

Company Registration Number (if applicable)

VAT Number (if applicable)

2. Accounts / Invoicing Contact

If different from the main contact above, please provide details for invoicing.

Accounts Contact Name

Accounts Email

Accounts Telephone

3. Credit Terms

• Credit terms: 30 days from invoice date

• Credit limit: To be determined by Prameera Ltd

• All orders are subject to acceptance by Prameera Ltd.

4. Portal Login Details

Your First Name *

Your Last Name *

Password *

Confirm Password *

5. Additional Information

Estimated Monthly Order Volume

How did you hear about us?

Declaration

I/We confirm that the information provided is accurate and that I/we agree to be bound by the Terms and Conditions of Trade of Prameera Ltd (trading as MyPharmacyBags). I/We understand that credit terms are 30 days from invoice date and that the credit limit will be determined by Prameera Ltd.

I confirm the above information is accurate and I agree to the Terms and Conditions of Trade of Prameera Ltd. I confirm this is a genuine UK pharmacy business application. *