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Health Point agent registration

Thank you for your interest in becoming a Dr Live agent partner. Fields marked (*) are required. Our team will contact you after verification.

The Dr Live team can see your NID and documents for verification purposes only. These documents are never published or used on any website.

A. Pharmacy owner

Pharmacy owner’s name *

Mobile number *

WhatsApp number (optional) Same as mobile number

Number used in the Dr Live app (optional)

The number you registered (or will register) with in the app

Owner’s photo (optional)

A clear face photo, like a passport photo

Choose photo

National ID (NID) — front (optional) Choose photo

National ID (NID) — back (optional) Choose photo

B. Pharmacy

Pharmacy name *

Google location (optional)

If you are at the shop, tap “Use my current location”, or paste a Google Maps link.

Use my current locationor paste a link below

Full address

District *Select district

Upazila (thana) *Select a district first

Union / municipality (optional)Select an upazila first

Street address (optional)

Pharmacy photos (optional)

Front with signboard and inside — up to 6, 5 MB each

Choose files

Documents (optional)

Trade licence, drug licence, etc. — photo or PDF, up to 5

Choose files

C. Consent

I confirm that all information is correct and that the Dr Live team may contact me and verify it. *

Submit application