Form

Interest Form

Thank you for your interest in MedMe! By joining this waitlist, you'll get free access to MedMe for three months. Please fill out the interest form below, and we'll reach out shortly.

First Name*

Last Name*

Email*

Phone Number*

Job Title*

Pharmacy Name*

City*

Country*

Website*

What clinical services do you currently offer at your pharmacy?

Flu & Immunisations

Common Ailments

Specialty

NHS New Medicines Service

Medication Optimisation (Structured Medication Review (SMR), Medicines: Care and Review (MCR), Medicines: Prescription Review (MPR), Medicines Adherence Reviews, Medicines Management Services)

Travel Health

Point-of-Care Testing

Health Checks (Blood Pressure Monitoring, Glucose Monitoring, Ear Health, Weight Loss, Men’s / Women’s Health)

Other

Is your pharmacy part of the Pharmacy First program?

Yes

No

Would you like our team to schedule a sales demo with you?

Yes

Is there anything else about your pharmacy that MedMe should be aware of?

Submitting this form indicates your agreement to be contacted for marketing purposes.