Register as a Delegate for the PfizerFlex™ Patient Support Program

Please provide the following details about you:

First name

Last name

Your AHPRA number

Your email address

State

Are you at a hospital, clinic or pharmacy?

Your postcode

Delegate's role

What is the name of your hospital/clinic or pharmacy?

Yes

No

Password

Your password must be at least 8 characters, at least one number, one uppercase, one lowercase and one symbol (e.g. !#$%*-_).

Confirm password

Please confirm by clicking the boxes below:

I confirm that I have reviewed and agree to the PfizerFlex™ Terms and Conditions and Terms of Use.

I consent to my personal information being collected, used and disclosed by Pfizer and its nominated third-party service providers for the purpose of administering the PfizerFlex™ Patient Support Program, in accordance with Pfizer's Privacy Policy.

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