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 *

Confirm your email address *

This will be your online account log-in name

Create a password *

Confirm your password *

Your password must be at least 8 characters, must contain at least one number, and include a mix of upper and lowercase letters.

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 *

We and our sister company, CliniMed Ltd, would like to update you occasionally about our relevant products and services. Please confirm whether you agree to us holding your details and to being contacted in the ways listed below.You can unsubscribe from our mailing lists at any time by clicking the link in any of our emails, calling Freephone 0800 585 125 or emailing info@securicaremedical.co.uk, and you can view our full privacy policy here. Please tick each relevant box: Yes! Please keep me up to date via...

Email
Phone
Post

My basket