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***As we are not a locum agency anymore, please use this form if you require an urgent cover and we will forward it to pharmacists within our ‘coalition of the willing‘. If any of them is available to do the shift, they will contact you directly. You will NOT be charged for this service.***

Your Name (required)

Your Email (required)

Company (required)

Where do you need the pharmacist (Address including postcode)

Date From dd/mm/yyyy (required)

Date To dd/mm/yyyy (required)

Rate (per hour) - enter 'negotiable' if this is the case (required)

Your telephone number - including dialing code (required)

Any Further information? - a brief description of nature of work; include breaks, support staff, parking etc.

Is this an Emergency (URGENT) booking? (less than 48 hours)

I accept the terms and conditions of service