Company Address Information

Please provide a valid phone number.
Please provide a valid email address.

Reason for request

Please provide details of how your company will use the NHPC file.
If multiple users within your company will use the file, please specify how each user will use it.
Provide the qualifications of each end user (e.g., doctor, nurse, pharmacist). Please specify any other relevant qualifications.
Will the NHPC file be reproduced, copied, edited, published, transmitted, modified, distributed, altered, downloaded, incorporated with other materials, or passed on to a third party?
If Yes, please provide further details. This information is required to incorporate authorised use and associated fees into the licence agreement.
Please list ALL the locations where the NHPC will be used.
Will the NHPC be accessed over a network (i.e., one site with multiple users)?
Specify the total number of end users who will have access to the NHPC.
If your company uses a Purchase Ordering System, please provide the Purchase Order Number.
Discounts are available for the following options:
If Yes, please specify the data you would be able to share.

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