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Quitmate Pharmacy Questionnaire
Pharmacy Name
(Required)
How does a pharmacy refer a patient to Quitmate?
(Required)
Customer fills out details on a pharmacy’s own unique referral page
Pharmacy fills out details on a pharmacy’s own unique referral page
Both A & B
None of the above
Where does the QR code on the pharmacy’s in-store collateral go?
(Required)
Quitmate.com.au
Pharmacy’s unique referral page
Pharmacy website
None of the above
Where does a pharmacy go to process any in-store or online Quitmate orders?
(Required)
Quitmate Portal
Quitmate Website
My Pharmacy Website
None of the above
How much does it cost to request a 3 month prescription from Quitmate? And what is the pharmacy referral fee?
(Required)
$20 and $0
$20 and $5
$50 and $5
Free and $0
Do Quitmate doctors need to talk to the patient?
(Required)
Yes, every time they place a request for a script
No, never
Sometimes, depending on the type of script requested
None of the above
