Set up your Subscription
Your Details
Your Name
*
First Name
Last Name
Your Phone
*
Please enter a valid phone number.
Your Email
*
example@example.com
Your Position
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Business Details
Pharmacy Name
*
Business Email
*
example@example.com
Business Phone
*
Please enter a valid phone number.
How many staff are in your pharmacy?
ABN
Website
Street Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about us?
Please Select
Head Office Company
Supplier Company
Web Search
Referral
Conference
Previous Customer
Newsletter/Article
Email Marketing
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Checkout
How would you like to checkout?
*
Pay now via Stripe
Send me an Invoice (choose this option for multi-pharmacy signup)
Select your subscription and quantity
QCPP Only Subscription ($450/year excl. GST)
Full Platform Subscription ($1200/year excl. GST)
Health Information Subscription ($395/year excl. GST)
For 10 or more pharmacies,
contact us
to discuss an enterprise agreement.
QCPP Only Subscription Quantity
Full Platform Subscription Quantity
Health Information Subscription Quantity
My Products
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( X )
Health Information Subscription
$
434.50
AUD
for each
month
)
QCPP Only Subscription
$
495.00
AUD
for each
month
)
Full Platform Subscription
$
1,320.00
AUD
for each
month
)
Name
*
First Name
Last Name
Signature
*
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