Buying Pharmlogic

Buying Pharmlogic

The Order Form below sets out the details for your contract with Pharmlogic. You are able to generate a draft form for your internal use or submit the Order Form to submit an order for your pharmacy/group. If you have any questions, do not hesitate to contact us at support@pharmlogic.co.uk
Your Details (Primary Contact)
Name*

First NameLast Name
Email*
Use an NHS email address if possible
Mobile Number*
Please enter a valid mobile number.
Role
e.g. Superintendent Pharmacist
Finance Details
Finance Contact Name*

First NameLast Name
Finance Contact Email*
example@pharmacy.com
Contracting Organisation's Details
Account Name*
e.g. Boots Retail Limited
Account Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How many pharmacies will be included in this contract?*
Please confirm who will be covering licence fees for this contract*
Please confirm who will be covering SMS Costs for this contract*
Pharmacy 1
Pharmacy 1 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 1 Name*
Pharmacy 1 Finance Contact Name*

First NameLast Name
Pharmacy 1 Finance Contact Email*
example@example.com
Pharmacy 2
Pharmacy 2 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 2 Name*
Pharmacy 2 Finance Contact Name*

First NameLast Name
Pharmacy 2 Finance Contact Email*
example@example.com
Pharmacy 3
Pharmacy 3 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 3 Name*
Pharmacy 3 Finance Contact Name*

First NameLast Name
Pharmacy 3 Finance Contact Email*
example@example.com
Pharmacy 4
Pharmacy 4 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 4 Name*
Pharmacy 4 Finance Contact Name*

First NameLast Name
Pharmacy 4 Finance Contact Email*
example@example.com
Pharmacy 5
Pharmacy 5 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 5 Name*
Pharmacy 5 Finance Contact Name*

First NameLast Name
Pharmacy 5 Finance Contact Email*
example@example.com
Pharmacy 6
Pharmacy 6 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 6 Name*
Pharmacy 6 Finance Contact Name*

First NameLast Name
Pharmacy 6 Finance Contact Email*
example@example.com
Pharmacy 7
Pharmacy 7 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 7 Name*
Pharmacy 7 Finance Contact Name*

First NameLast Name
Pharmacy 7 Finance Contact Email*
example@example.com
Pharmacy 8
Pharmacy 8 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 8 Name*
Pharmacy 8 Finance Contact Name*

First NameLast Name
Pharmacy 8 Finance Contact Email*
example@example.com
Pharmacy 9
Pharmacy 9 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 9 Name*
Pharmacy 9 Finance Contact Name*

First NameLast Name
Pharmacy 9 Finance Contact Email*
example@example.com
Pharmacy 10
Pharmacy 10 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 10 Name*
Pharmacy 10 Finance Contact Name*

First NameLast Name
Pharmacy 10 Finance Contact Email*
example@example.com
Pharmacy 11
Pharmacy 11 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 11 Name*
Pharmacy 11 Finance Contact Name*

First NameLast Name
Pharmacy 11 Finance Contact Email*
example@example.com
Pharmacy 12
Pharmacy 12 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 12 Name*
Pharmacy 12 Finance Contact Name*

First NameLast Name
Pharmacy 12 Finance Contact Email*
example@example.com
Pharmacy 13
Pharmacy 13 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 13 Name*
Pharmacy 13 Finance Contact Name*

First NameLast Name
Pharmacy 13 Finance Contact Email*
example@example.com
Pharmacy 14
Pharmacy 14 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 14 Name*
Pharmacy 14 Finance Contact Name*

First NameLast Name
Pharmacy 14 Finance Contact Email*
example@example.com
Pharmacy 15
Pharmacy 15 ODS Code*
Enter the ODS / NACS code in uppercase
Pharmacy 15 Name*
Pharmacy 15 Finance Contact Name*

First NameLast Name
Pharmacy 15 Finance Contact Email*
example@example.com

Pharmlogic Modules
Please note the Annual Licence Fee does not include VAT or SMS Costs.

Select the modules you are interested in purchasing and the form will generate a price for you, including any discounts that apply.
Select Your Modules
Please select the individual modules you'd like to purchase:

Pharmlogic Messaging (Individual & batch messaging)
TOTAL MONTHLY FEE
TOTAL MONTHLY FEE + VAT*
*Excludes SMS Costs which will be invoiced separately and charged using the direct debit details provided. SMS Costs are calculated based on fragment usage, where a fragment is 160 characters of text and on average, one Pharmlogic text is made up of 2.5 fragments. For Pharmlogic orders, SMS Costs are payable for SMS Fragments sent the previous calendar month at 2.57p plus VAT per fragment (if paid by Direct Debit) or 2.67p plus VAT per fragment (if not paid by Direct Debit).
Preferred Start Date*

DayMonthYear
This is the date you'll be able to access and use Pharmlogic. Contracts run for 12 months from the switch-on date. If we are unable to provide access on your requested Switch-on Date, we will not charge you before you have access and we will confirm your Switch-on Date with you.

Direct Debit Setup
Account Holder Name*
Name of Account Holder

First NameLast Name
Branch Sort Code
Bank/Building Society Account Number
Full Address of Bank

Street Address

Street Address Line 2

CityCounty

Post Code
Signature

Clear
Date

DayMonthYear
Date
Licence Fee payment terms*
Please specify if your pharmacy would like to pay Licence Fees annually or monthly. Please note that SMS Costs are charged monthly at the end of each month.
After you complete the Order Form, you'll be redirected to set up a Direct Debit mandate.

Order Now
Click Order Now to submit your Order Form to Pharmlogic. Once it has been submitted and you accept our Terms and Conditions below, you'll be given access to the Pharmlogic Products you've ordered on your preferred switch-on date.

By providing payment details and completing/submitting this Order Form, you confirm that you are an authorised signatory and are able to agree these terms on behalf of the purchaser under this contract.

If you have any questions before submitting, do not hesitate to contact us using our live chat on our website.
Please submit any comments or questions here.
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Buying Pharmlogic

Your Details (Primary Contact)

Finance Details

Contracting Organisation's Details

Pharmacy 1

Pharmacy 2

Pharmacy 3

Pharmacy 4

Pharmacy 5

Pharmacy 6

Pharmacy 7

Pharmacy 8

Pharmacy 9

Pharmacy 10

Pharmacy 11

Pharmacy 12

Pharmacy 13

Pharmacy 14

Pharmacy 15

Pharmlogic Modules

Select Your Modules

Direct Debit Setup

Order Now