Providers | Register as a CPD Provider

Register as a CPD Provider

Use this form if you wish to register as a new CPD Provider with the Pharmacy and Poisons Board

Provider Details (mandatory)









DECLARATION I declare that to the best of my knowledge and belief that the particulars I/ we have given in this form are correct and complete.




Pertinent Attachments (mandatory)






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CPD Administrator

First Name

Mobile No

Middle Name

Email

Last Name

Postal Address/Code

ID Number

Town