Pharmacy Partner Application

Contact Person

First Name *

Last Name

Phone Number *

Email Address *

LINE ID

Primary contact for our partner team

Pharmacy Information

Pharmacy Name *

Service Zone *

Pharmacy License Number *

Responsible Pharmacist Name *

Pharmacy Address *

Latitude *

Longitude *

How to find coordinates: Open Google Maps > Right-click your location > Copy coordinates

Types of Products

💊 OTC Medicines/ยาไม่ต้องใช้ใบสั่ง 📋 Prescription/ยาตามใบสั่งแพทย์ 🌿 Vitamins & Supplements/วิตามิน 🩺 Medical Devices/อุปกรณ์การแพทย์ 👶 Baby & Mother/แม่และเด็ก 💄 Cosmetics/เครื่องสำอาง 📦 Other/อื่นๆ

Current Delivery Platforms

Which platforms is your pharmacy currently on?

Operations

Min Prep Time (minutes) *

Max Prep Time (minutes) *

Operating Hours

Menu Size

Commission

💊 Fixed 10% Commission Rate

Pharmacy partners have a flat 10% commission rate — fixed, non-negotiable. This maintains consistent healthcare service standards across our platform.

Logo & Images

Pharmacy Logo *

Upload logo

Square image, max 2MB

Cover Photo

Upload cover photo

Create Account

Password *

Must include uppercase, numbers and symbols

Confirm Password *

Additional Notes

I agree to be contacted by TanJai regarding partnership opportunities and accept Terms & Conditions and Privacy Policy

Our team will contact you within 24 hours

💊 Become a Pharmacy Partner

Pharmacy Partner Application

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