Account Application

Thank you for your interest in our company.

We would like to assure you that we will do our utmost to provide you with the required products and services (subject to availability) in a timely manner.

In order to open an account for order processing please complete the Customer Account Proposal Form & Customer Terms & Conditions attached for our records which we are legally obliged to collect. Some of the T & C’s do not apply as your account is prepayment but this is our standard T&C’s for all customers.

PLEASE BE AWARE THAT WE CANNOT SUPPLY DIRECT TO THE GENERAL PUBLIC OR TAKE ENQUIRIES FROM THE GENERAL PUBLIC. PLEASE ASK YOUR GP TO CONTACT US.


Please fax the 2 completed forms to +44 (0)1923 839983 or scan and e-mail them to medicines@jolinda.co.uk at your earliest convenience.

By completing these forms you agree to our terms and conditions of sale, terms and conditions of buying and the declaration to be signed on the account proposal form.

Customer Account Proposal Form

Customer Account Terms & Conditions



New Supplier Verification Form