Registration

First Schedule

APPLICATION FOR REGISTRATION OF A PHARMACY

 

Section 1 - Type of Application




Section 2 - Type of Pharmacy




Section 3 - Pharmacy Information

TO

Section 4 - Pharmacy Ownership Information

The Pharmacy identified in Section 3 is owned by:






Section 5 - List of Owner's Address

Section 6 - Ownership of Existing Registered Pharmacy

Does the Owner listed in Section 5 own a registered factory/warehouse?

Yes No

Planning to import Pharmaceuticals?

Here's what you need to know...