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Add your company to the AUK suppliers directory

If you would like your company to be included in the suppliers directory, please fill in the form below in order to begin the process of being included. The cost of inclusion is 70 per year.

Please ensure all text is well-written, error free and presentable for publication on our website.

When we have received payment and approved your entry, you will be informed and your company's details will be accessible to users of our website.

Company name *

Description of business *

This description should be concise and give our website users a quick summary of the services or products they can expect.

Products and services

Please select from the drop-down menus below.

Main products and services *

Other serivces, if applicable

Other serivces, if applicable

Business address (for customers)

Line one *

Line two

Town or city *
 

County

Country *

Postcode *

Opening hours

Directions, if required, and notes regarding accessibility

Email address for customer use

Telephone number *

Account details

These details will not be made public

Your first name *

Your last name *

Your email address *

Password *

Retype your password

 

Website address

Do you have an online shop or mail order service?
 

Do you have any private consultation rooms?
 

Do you offer discounts to AUK members?
 

Details about discounts

Is your company NHS registered?
 

Terms and conditions *

I have read and agree to the terms and conditions for inclusion

* indicates a required field

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AUK

Alopecia UK is a registered charity number 1111304 and Scottish registered charity SCO44702
All content is © Alopecia UK 2017

Site by Jellymould Creative with C4 Multimedia