Register

Tell us about yourself

What is your current position? *

Cosmetic Nurse

Doctor

Nurse Practitioner

Dentist

Dermatologist

Other

APHRA number *

How can we contact you?

Company Name *

Delivery Address Line 1 *

Delivery Address Line 2

Suburb *

State *

Postcode *

First Name *

Last Name *

Mobile Phone Number *

Email *

Password *

Confirm Password *

Elegantia is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as well as other content that may be of interest to you. If you consent to us contacting you for this purpose, please tick below to say how you would like us to contact you:

I agree to receive other communications from Elegantia.

You may unsubscribe from these communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our Privacy Policy.

By clicking submit below, you consent to allow Elegantia to store and process the personal information submitted above to provide you the content requested.

Legal Disclaimer: In accordance with the Poisons Act 1964 (WA) and the Therapeutic Goods Act 1989 (Cth), Schedule 4 medicines must only be supplied to authorised health practitioners. By completing this purchase, the buyer confirms their legal authority to procure and use this product and agrees to comply with all applicable laws and regulations.

Register

Login

Register

Tell us about yourself

How can we contact you?