Order Form

Please fill out your pharmacy details below. Pharmlytix uses artificial intelligence to assist pharmacists by analyzing MARs and suggesting draft clinical recommendations — for pharmacist review and approval. Pharmacists retain full control and clinical authority over all recommendations.

Pricing: $499/Organization/Month (up to 10 users) or $99/User/Month

Pharmacy Name/Organization Name*

# of Locations (estimate)*

Contact First Name*

Contact Last Name*

Email*

Phone*
By providing your phone number, you agree to receive temporary passwords and verification codes via SMS. Each user must provide a unique phone number. Message and data rates may apply. For more details, please review our Privacy Policy and Terms & Conditions.

Address*

City*

State*

Zip*