CLINIC SIGN UP

Please fill in the information below to apply to become part of the PFF family.

General Details

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Clinic Details

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Presciber Details (if required)

Account Login Details

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Please Read Carefully

Please ensure that you carefully double check ALL details supplied to us prior to submitting your form.

Errors & incorrect information may result in initial system set up failure - This will cause problems/delays with you receiving customer payments.

Please note we aim to have all clinics live within an estimated time frame of 2 weeks from the date we have received ALL information required.

We look forward to working along site you, thank you for choosing us.

PFF

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