Register a new Account

New Customer Registration

This form is for receiving regular ongoing supplies through the SecuriCare Home Delivery Service. If you only want one-off samples without joining our home delivery service, please visit our sister company, CliniMed.

Your Details

Account registration is only open to UK residents.

First name *

Surname *

Email Address * This will be your online account log-in name

Choose Password * (minimum 6 characters) Remember to make a note of this!

Telephone *

Your address

Look up your address below. This will be used as your default delivery address (you can edit this and add additional addresses later).

Start with postcode / street *

Your Doctor’s Details

Doctor’s name *

Surgery name *

Surgery phone number *

My basket