Skip to main content
Menu
CME Talk
Talk to a Dr
How Does It Work
FAQs
Dr Register
Dr Sign In
Close Search
Home
»
E-Registration
Are you registering for a WellAway account as an individual doctor (i.e. not affiliated with any clinics or businesses)? If yes, please register
here
instead.
"
*
" indicates required fields
Business/Clinic Information
Name of Business/Clinic
*
Business Registration Number
Business Address
*
Street Address
Address Line 2
ZIP / Postal Code
Registering Doctor
Doctor's Name
*
DOCTOR'S DESIGNATION (E.G. MEDICAL DIRECTOR, PARTNER)
*
Doctors's MCR Number
*
Doctor's Email Address
*
Doctor's Mobile Number
*
Contact Details for Administrative and Billing Purposes
Are you an existing customer of Pan-Malayan Pharmaceuticals? If yes, we will use the same contact details for WellAway’s administrative and billing matters.
*
Yes
No
Name of Contact Person
*
DESIGNATION (E.G. CLINIC MANAGER, ACCOUNTANT)
*
Email Address
*
Office Number
*
General
Referred By (Indicate N.A. if not referred by anyone)
*
T&C
*
I agree to WellAway's
Terms of Service
*
Phone Number for Verification
*
Change?
Close Menu
CME Talk
Talk to a Dr
How Does It Work
FAQs
Dr Register
Dr Sign In