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Medmate KYC Form
Pharmacy Trading Name
(Required)
Please include your FULL pharmacy name. For example, if you are called Amcal Pharmacy Rowville do NOT just put Rowville Pharmacy.
Registered Business Name
(Required)
Bank Details
(Required)
BSB
Account Number
Copy of Bank Details
(Required)
Please upload a bank statement showing the name of your Pharmacy and BSB. No other details required.
Max. file size: 1 GB.
