Pharmacy Registration Step 1

The information entered below will be visible to 1000’s of patients online.

Format your information correctly, using proper capitalization and spacing.

Please double check your information for accuracy and typos.

Pharmacy Information

Pharmacy Name - Note: Please do not use any special characters in this field. *

Pharmacy Email *

Pharmacy Phone *

Website (Format = http://www.yourwebsite.com)

Street Address 1 *

Street Address 2

City *

State *

Zip Code *

Pharmacy Logo

Drop your file here or click here to upload You can upload up to 1 files

Contact Information

First Name *

Last Name *

Mobile Number *

Set Your Password

Pharmacy Password *

Confirm Pharmacy Password *

Vaccination Information

Duration of Vaccine Appointments *

5 Minutes
10 Minutes
15 Minutes

Screening Form

Drop your file here or click here to upload You can upload up to 1 files

If you would like your patients to complete a prescreening form prior to their arrival for vaccination, please attach that form above. During the booking process, the patient will be able to download the form for completion.

Drugstore2Door Information

Are You Currently a Drugstore2Door Partner? *

If No, Are You Interested in More Information? (optional)

Yes! I want an e-commerce platform for my patients!
No, I just want the free COVID booking system.