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Sign-up application form

Please ensure you have all the correct details before proceeding as you will not be able to change this

Registration reference number: GMC, pharmacists, technician, nursing or Homecare Pfizer association number
You will be able to update this during adding a request and the ordering process

Please ensure you highlight all of your practicing specialties now, as this will require a helpdesk change if incorrect at a later date.

For example, if you are an oncologist practicing in lymphoma, please highlight: oncology, medical oncology, clinical oncology, haematology, haematology; oncology

Enter email of Pfizer contact supporting you in this registration
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