Join Self Care now!

Becoming a Self Care pharmacy couldn’t be easier!

Use the online form below, or download and complete the printed version of the form, email it to membership@psa.org.au or fax to (02) 6285 2869. You will receive all the materials and support you need.

Pharmacy details

Pharmacy business name *
Pharmacy business street address *
Suburb or town *
State or Territory *
Postcode *
Phone (include area code if not mobile) *
Fax
Pharmacy email (valid email required)
Contact's first name *
Contact's last name *
Corporate marketing group (if applicable)

Owner/manager's details (for invoicing purposes)

First name *
Last name *
Owner/manager's email (valid email required)
PSA member number *
If you own another pharmacy enrolled in the Self Care program, please specifiy:
Name(s) of other pharmacies
Self Care number(s) for the other pharmacies

Payment preferences

The complete Self Care program is $860 for 12 months. Please indicate your payment preference below. You will receive payment instructions in your confirmation email.
Payment method *

Declaration by pharmacy owner/manager

I understand that access to the Self Care program is contingent on me remaining a financial member of the Pharmaceutical Society of Australia.

Thank you

Thank you for your Self Care application. You will receive an email, including payment details, at the address you gave under owner/manager's details.

Downloadable Self Care application form

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