New to PharmaNet? Sign up here.

Thank you for your interest in Medinet Access to PharmaNet. Please complete the form below and we will contact you to gather a little more information. Then we will manage the MOH application process for you.

All information entered is kept confidential and will not be shared with third parties.

You will be given an opportunity to enter more physicians after you click on the send button.

Practice Details

Practice name
Address
City
Postal code
Telephone
Fax

Personal Details

Last name
First name
Middle name
College
College ID
MSP number
Practitioner's Personal Email
(for security reasons)
Practitioner's Mobile #
(for two factor security only)
How did you hear about us?
All fields except middle name are required
Send info to Medinet Start over