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PREMIUM

LOCUMS

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Home
About
Register
- Pharmacy Employers
- Pharmacist Job Seekers
Jobs
Contact

Registration for Pharmacy

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Pharmacy Name

Pharmacy Address

Phone

Email

What Email address would you like invoices to be sent to (By Locum Pharmacists and Premium Locums)?

Dispensary Computer Systems

Average Number of scripts per day

Dispensary Technician?

Yes No

Do you require a Locum Pharmacist?

Yes No

If so what date and time do you need the Locum Pharmacist to work?

What hourly rate are you prepared to pay the Locum Pharmacist?

Where can the Locum Pharmacist park their car?

If the Pharmacy is in a Rural or Regional Location will you pay the Locum Pharmacist 80c/km round trip

Yes No

Are you responsible for a methadone program?

Yes No

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

Yes No

POS Computer System

Pharmacy Opening Hours

Would you like to register for permanent staff?

Yes No

If so, please provide details that will make your position appealing to potential applications

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

Name of Authorised Person and Position

Date

Please download and read our Pharmacy Business Agreement to ensure you understand the agreement details.

Acceptance

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.

Digital Signature

Congratulations!

Well Done,
You Did It!

We now have your registration details and will be in touch shortly.

If you have any questions, feel free to ring us on 0488 793 253 or use the websites contact form to ask any questions.

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PREMIUM

LOCUMS

Registration for Pharmacy

Congratulations!

Well Done, You Did It!

Well Done,
You Did It!