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CLINIGEN

Management and supply of unlicensed and specialist medicines

Structured implementation of named patient programmes

Partnership approach to Global Market Access Planning

Patient Access and Product Life Cycle support

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Please note that due to the ‘The Medicines for Human Use Regulations (2005)’, we are unable to offer access to non-healthcare professionals.
If you would like to contact us regarding our products and services,
please click here.

Please confirm what type of medical professional you are and press "Submit" to proceed.

	Retail Pharmacy
	Dispensing Doctor
	Hospital Pharmacy
	UK Registered Healthcare Professional
	Overseas Registered Healthcare Professional
	Other

Please note due to the ‘The medicines for Human Use Regulations 2005’, we are unable to offer access to non-healthcare professionals.

Retail Pharmacy No.	:
		( This is a 7 digit number issued by the RPSGB for every pharmacy)

Post Code	:

	Please fill Retail Pharmacy Number & Post Code then click on "Next" to make next screen accessible.
		Fields marked as are mandatory

:

Registration Number

:

Name of Pharmacist

:

Country of Registration

:

Delivery Address Line1

:

Delivery Address Line2

:

Delivery Address Line3

:

Delivery Address Line4

:

Delivery Address Line5

:

Country

:

Post Code

:

Pharmacist No.

:

Forename

:

Surname

:

:

:

:

:

Username

:

Password

:

Verify Password

:

Please check here if the Account's Department address is same as above.

Invoicing Name	:

Address Line1	:

Address Line2	:

Address Line3	:

Address Line4	:

Address Line5	:

Country	:

Post Code	:

Billing Information

Contact Name	:

Telephone No.	:

Fax No.	:

Mobile No.	:

Email address	:

Terms and Conditions

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