Register new company · Sciensus Axcess

Sciensus Axcess is only intended for Healthcare professionals, retail pharmacists and wholesalers. To comply with regulations, as part of registering we need to be able to determine you have the appropriate professional registration and/or license to be able to order pharmaceutical products. Please either include your professional registration number and/or the license certification you may have as a Hospital pharmacy, retail pharmacy or wholesaler, which you can upload in files section below. By registering for the Sciensus Axcess portal you accept the Terms of Use, Privacy Policy and Cookie Policy.
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Type of Product

LicensedUnlicensed

Company Name

VAT Number

Type of Business

Your Contact Details

Salutation (Title)

First Name

Last Name

Telephone

e.g. +44(0)123456789

Fax

Role

Preferred Language for Communications

Default Delivery Address

Address Name

Line 1

Line 2

Line 3

City

ZIP/Postal Code

Country

Siret Number

CIG Number

Default Invoice Address

Address Name

Line 1

Line 2

Line 3

City

ZIP/Postal Code

Invoice Country

Delivery Contact

Same as My Contact Details

Delivery Contact First Name

Delivery Contact Last Name

Delivery Telephone

e.g. +44(0)123456789

Delivery Fax

Delivery Email

Invoice Contact

Same as My Contact Details

Invoice Contact First Name

Invoice Contact Last Name

Invoice Telephone

e.g. +44(0)123456789

Invoice Fax

Invoice Email

Default Quality Contact

Same as My Contact Details

Quality Contact First Name

Quality Contact Last Name

Telephone

Fax

Default Recall Contact

Same as My Contact Details

Recall Contact First Name

Recall Contact Lastname

Telephone

Fax

License information

Professional Registration No.

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