PCPA


	supporting pharmacists in primary care

PCPA Membership Application Form

The Primary care pharmacists' Association ( PCPA ) was established for the benefit of all pharmacists with an active interest in primary care pharmacy. Particularly relevant to those pharmacists who provide prescribing and pharmaceutical advise within a primary or community pharmacy setting.

The PCPA is now recognised as an important voice for primary care pharmacy participating in many national initiatives and forms. Membership will help you influence the development of pharmaceutical advice, prescribing support, medicines management services and benefit patient care in your locality as well as providing you with some valuable and unique resources.

Membership fees:

Full membership - £20 ( this is currently a one off fee to cover administration )
Group membership - £175 per annum ( for up to 10 and multiples of 10 therafter )
Associate membership - £50 ( for health professionals working within the pharmaceutical industry)

To apply for membership please fill out this form and we will invoice you for your membership fee.
All fields marked with a * are required.

Title:*

First Name:*

Surname:*

Job Title:

Organisation Name:

Application Type:

Individual Group Associate

If "Group" above, number of members:

Address (work):

Postcode:*

Email Address:*

Please note: If you do not have an email address, please contact Michelle Kaulbach.

Home Phone No:

Work Phone No:

Mobile Phone No:

Fax No:

Preferred Username:*

Password:*

Comments:

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