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Drug Comparison Call Back Request Form
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* Indicates required question
Email
*
Your email
Full Name
*
Your answer
Pharmacy Name
*
Your answer
Pharmacy Postcode
*
Your answer
Contact Number
*
Your answer
What Suppliers do you currently use in your Pharmacy
*
AAH
Alliance
Phoenix
Bestway Medhub
BNS Colorama
Ethigen
Lexon
OTC Direct / Cavendish
Sigma
Trident
Other:
Required
Are you signed up to any Price Comparison / Cascading System?
*
None
Other:
Do you belong to any Buying Group?
*
Your answer
Number of Branches?
*
Your answer
Average Number of Items per Branch?
*
Your answer
Would you like Drug Comparison to arrange a Demo of the Software? If Yes, please book it via our website https://www.drugcomparison.co.uk
*
Yes
No
Other:
How did you hear about us?
*
Your answer
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