Pharmacy Employers | Pharmatemp

Name *

First

Last

Pharmacy Address *

Phone *

(Please indicate business, mobile, home)

Email *

Contact Person and Position

Dispensary Computer System

Average Number of Scripts Per Day

Dispensary Technician?

POS Computer System

Number of Shop Staff (Pharmacists)

Please indicate Full Time or Part Time

Pharmacy Opening Hours

Hours Required to be worked by Pharmacist

Would you like to register for a permanent position?

If so, please provide details (i.e. hours, incentives, etc.) that will make your position appealing to potential applications

Are you responsible for a methadone programme?

Are you responsible for a nursing home or other special care facility?

Please specify any other particular requirements associated with the pharmacist’s duties:

Name of Authorised Person and Position *

Date

Completion of this registration form indicates acceptance of all terms and conditions as outlined on the attached Agreement. Any changes to the fee structure will be notified in writing. *

Please check box to accept.

Name

You can view and download the Agreement here

Alternatively, you can also register using this Interactive Registration Form