Pharmacy

Do you own or manage a Pharmacy?

We are the supplier of the Cortex Health supplement range and are happy to process your order. You will need to create an account with us to be able to order these products to your pharmacy. Please create a an account using the submission form below and we can then dispatch your order.

As you know, the management of PKU is both adherence to protein formula and also a low protein food diet. We have possibly the largest range of low protein foods and recently have offered a combine and save to our patients that use our supplements. If you could please pass this onto your patients who order our supplements, that would greatly be appreciated and help them save on monies as well. For example they could save at least $30 to $60. We are also able to delivery formula directly to the patient for convenience.

If you or your patient would like to know more information about this, please do not hesitate to contact us via email at info@cortexhealth.com.au or 1800 367 758.

Please note – an invoice will follow to your nominated accounts manager, and delivery for prescription products are not charged to the patient or the pharmacist.

Welcome on board. We look forward to helping support you and your patient.

Pharmacies with existing accounts are still able to fax or email their order forms as done previously with their existing personalised order form. You do not need to create an account below.

Pharmacy
Account Registration

Business Details

Company name*

ABN*

Trading Name*

Structure*

Postal Address*

Suburb*

State*

Postcode*

Director/Proprietor Details

First Name*

Surname*

Last Name*

Residential postal address

State*

Postcode*

Account department / account contact person details

First Name*

Surname*

Last Name*

Postal Address*

Email*

Phone number*

Mobile*

Authorised practitioner/pharmacist details

Name*

AHPRA no:

Name*

AHPRA no:

Preferred method of ordering

Email Fax

Declaration

The Declaration and Personal Guarantee below is to be signed by

The directors of the company/owners of the business applying for this account. An authorised representative of the company*

*I agree to maintain the account to agreed terms, and accept liability jointly and severally with theproprietor.
I the undersigned hereby:

Declare that the facts given are true and correct, acknowledge that credit facilities may be withdrawn without prior notice, jointly and severally guarantee payment to Cortex Health Pty Ltd of monies due by my/our business/company.
I agree to notify Cortex Health Pty Ltd should any change in the ownership of the business/company take place.

First Name*

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Position*

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Date*

Terms

Standard terms of trade are 15 days from invoice date for customers who qualify for a credit account, unless specified otherwise. Credit limit restrictions may apply. Accounts exceeding the granted credit limit will require payment prior to the due date.

Method of payment

Settlement of accounts is accepted by Direct Deposit, Cash, Cheque, AMEX, Mastercard or Visa. Credit card payments attract a 3.5% surcharge.

Overdue accounts

Accounts in excess of 60 days past due may be charged interest at business overdraft rates of the outstanding balance per month. Accounts exceeding trading terms will be placed on hold and further credit withheld at the discretion of Cortex Health. Cortex Health reserves the right to recover any additional costs incurred in relation to the collection of any overdue debt. Cortex Health reserves the right to impose any restrictions or withdraw credit facilities as it deems fit.

Orders

All orders must include your Account Code and Product Codes. Cortex Health will not take responsibility for mistaken goods where product codes have not been quoted. There are no minimum orders.

Back Orders

Cortex Health will make every effort to ensure products are always available in stock. Items may at times become unavailable due to circumstances beyond our control. Cortex Health cannot be held responsible for out of stock items in these instances. Should you wish to receive backorders Cortex Health will ship these items automatically once the stock has become available. Please contact our friendly customer service team to advise how you wish to have your back orders handled.

Refrigerated items

Stock which requires refrigerated storage will remain the responsibility of the customer to check for instructions upon receipt of goods.

Practitioner Requirement

Practitioner products are available only to qualified practitioners who have undertaken formal training and received registration.

Pharmacy

Do you own or manage a Pharmacy?

Pharmacy
Account Registration

Business Details

Director/Proprietor Details

Account department / account contact person details

Authorised practitioner/pharmacist details

Declaration

Terms

Method of payment

Overdue accounts

Orders

Back Orders

Refrigerated items

Practitioner Requirement

Sushi – Avocado and Tomato Nigiri Style

Taco “Beef”

Pharmacy

Do you own or manage a Pharmacy?

Pharmacy Account Registration

Business Details

Director/Proprietor Details

Account department / account contact person details

Authorised practitioner/pharmacist details

Declaration

Terms

Method of payment

Overdue accounts

Orders

Back Orders

Refrigerated items

Practitioner Requirement

Sushi – Avocado and Tomato Nigiri Style

Taco “Beef”

Pharmacy
Account Registration