Retail Sign-Up Form

Make enrolling in your adherence program quick and easy

  • Retail Sign-Up Form

Having materials for your staff to explain your adherence program is one thing, but being able to provide leave-behind brochures that are self-explanatory is vital. If you leave behind sign up forms in doctor's offices or with school administration, will your potential customers understand the program? Can you give it to a current customer to refer a friend and they will understand what your program is all about? 

TCGRx has designed this sign-up form with input from dozens of customers' valuable input to ensure that the marketing you are investing in, will be beneficial to all parties involved. We have detailed what adherence is, what it will do for your patients, and exactly what your customers can expect. This customizable brochure allows you to detail your specific program - Are there sign up fees? Shipping fees? Are refills automatic? All of those questions are answered by you prior to printing, to make sure this brochure explains your specific program. The right side has a perforation for easy sign-up and tear-off to give to the pharmacy, and the back has room for your pharmacy logo and contact information. 

We also recommend ordering our countertop stands so you can keep forms in an organized location, be it your drop off/pick up windows, a school nurse's office, or a physicians exam room.

The sign-up forms include:

  • Your choice of 1 campaign from 12 campaign designs
  • Edits to customize the form to your specific program

Available for order in quantities of 150/pack.

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Customer Reviews

When TCGRx developed the InspectRx, this provided a solution for patient safety. Making sure that it is accurate and it is the right med, right pack, for right patient for the right time was paramount.

Jon Martin, Director of Business Development
Gayco Healthcare

Hospital Pharmacy

TCGRx serves the hospital market by helping to reduce inventory, preparing for barcode scanning, and ensuring safety and accuracy.

Retail Pharmacy

Our products will help you expand your markets, whether it’s through adherence or outpatient products or services.

Long Term Care

Whether its better inventory space management or new technologies for compliance and adherence, we know that you need to supply meds faster, safer, and with limited space.

Nutraceutical Pharmacy

Our products will help you expand your markets, whether it’s through adherence or outpatient products or services.

Outpatient Pharmacy

TCGRx is committed to working with you to optimize space, labor, and inventory management aspects of your pharmacy through automation and technology.

Central Fill Pharmacy

Find the tools you need to supply meds faster, safer, and on a larger scale.

Want to improve your workflow?

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