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New client form

    General information (separately for each manufacturing / wholesale site)

    Company address

    Manufacturing / Wholesale site details

    Licenses and authorizations (issued by a competent authority)

    Quality management system

    Scope of the entity authorization (the entity is authorized to trade in products)

    Designated contact people

    Responsible person

    Responsible person deputy

    Person responsible for narcotics and psychotropic substances

    Qualified person

    Person responsible for claims and returns

    Consents

    Email Channel*

    Phone channel*

    SMS channel*

    Consent*

    Information Clause*

    * Required fields