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Please ensure your information is up-to-date.

IMPORTANT NOTE: The information on this form is your information only and not the information of anyone else.






Prefer to fax or mail in your membership and insurance renewal? Not a problem! 


Download Pharmacist Membership application
Download Insurance application




The supplementary insurance is a supplement for an existing insurance. It is not a stand-alone insurance.
The insurance is usually an add-on, if an employer already pays for the insurance.
It is important to note that you must have VALID primary coverage in order for the supplementary insurance to respond.
Please ensure that the primary coverage has not lapsed, was cancelled nor is invalid. This is not a ‘stand-alone’ insurance.