Profarma Registration Form


Dear User,
Welcome to the Profarma online registration.Please complete the fields below and click on "Register" to send us your registration. Please proceed as follows:
Step 1: Fill out and send in the registration form now
Step 2: Send us your identification certificate
Step 3: Verify your registration request

Your registration request will be processed immediately. All personal information will be handled in accordance with Albanian and international standards of privacy. All fields marked with * are required for the registration process.

Step 1: Fill out and send in the registration form now

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Salutation(*)
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Title(*)
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First Name(*)
Please type your first name.

Last Name(*)
Please type your last name.

Hospital / Institution(*)
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Special Field
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Street(*)
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Postal Code(*)
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City(*)
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Country(*)
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Phone Number
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E-mail(*)
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Login Name(*)
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Password(*)
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Verify Password(*)
Please verify your password !

Terms of use(*)
Please agree to the terms of use.

Terms of use
I consent to the storage of details provided by me pertaining to my person, profession and work address by Profarma Sha, Rr.Myslym Keta, Ish Antibiotiku,Tirana, Albania (hereinafter called "service provider") and to the disclosure of the data to the service provider's affiliates. I understand I have the option to object to the data recorded by the service provider pertaining to me and to the drafting of anonymous user profiles. I realize I may have this data corrected, deleted, modified or amended upon request.

 

Step 2: Send us your identification certificate

Please send us your identification certificate stated below by uploading it here, by e-mail or transmit a scan by mail to:
Profarma Sha
Rr.Myslym Keta, Ish Antibiotiku
Tirana, Albania
E-mail: info@profarma.al

Eligible identification certificates are:
License to practice medicine (approbation)
Pharmacist license
A copy of your business registation certificate

Do you have any questions?
If you have any further questions please do not hesitate to contact us under:
Phone: +355 42 389602
E-mail: info@profarma.al

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