Welcome

New Customer Registration

Welcome! Fill out the form below to create your account with Avoma Pharma.
We’ll get in touch to confirm your details and next steps.

    Cash Account Application Form

    Please complete the form below to register a cash account with Avoma Pharma.

    Business Details








    * We’ll use this email for all official communication.



    * Street name, building name/number, floor, and any nearby landmarks.

    Contact Persons

    Contact Person 1 (Required)





    * Include country code for international numbers.


    Contact Person 2 (Optional)


    * Include country code for international numbers.

    Required Documents


    Premises Registration Certificate


    Pharmacist Registration Certificate


    Business Registration Certificate


    ERS Tax Compliance Certificate


    Directors’ ID Documents


    Please ensure all uploaded documents are clear and legible. Maximum file size is 5MB per document. Only PDF, JPG, and PNG formats are accepted.