TAKE CONTROL OF YOUR FUTURE

For a free copy of our 16 page, four-color corporate brochure which details more information on how you can become a part of the Medicap Pharmacy team, please fill out the form below and send it to us here at our Web site:

	
	

	

		

		
		
		
		
	
	

		
* First Name: 
		

	

		
* Last Name: 
		

	

		
* Street Address: 
		

	

		
 
		

	

		
* City: 
		

	

		
* State: 
		

			

				

					

					
  * Zip: 
					

				
			
	

		
  Country: 
		

	

		

			

				

					
  Registered Pharmacist 
					

					
   Interested  Investor 
					

				
			
	

		
  Daytime Phone: 
		

	

		
  Evening Phone: 
		

	

		
* E-Mail Address: 
		

(required for request confirmation)
	

		
  Current Employer: 
		

	

		
* How did you hear about Medicap® Pharmacies: 
		

			Saw or visited a Medicap® Pharmacy

			Friend or collegue

			Magazine ad

			Trade show

			Web site

			Direct Mail

			Other: 

		
	

		
Location of Interest for your Medicap Pharmacy franchise:
	

		
  City: 
		

	

		
  State: 
		

	

		
 

	
	

		

		( * = required fields )
		


		
		

			
            Special Notice to Potential Investors

            Medicap Pharmacies, Inc., requires that every franchise agreement include a registered
            pharmacist as owner/operator with a minimum of
            20% equity interest in a specific location.

            If you are an investor who knows of a qualified registered pharmacist
            who may be interested in partnering with you in a Medicap Pharmacy franchise agreement,
            please use the form above to contact our corporate office for more details. The
            responsibility of finding a qualified pharmacist is yours, but Medicap Pharmacies, Inc.,
            will assist in any way possible to facilitate a partnership with qualified pharmacists.

            

            Whether you are a registered pharmacist or interested investor complete the form above, or contact:

            

			Franchise Development

			Medicap Pharmacies, Inc.

			4350 Westown Parkway #8 - 400

			West Des Moines, Iowa 50266


			1-800-445-2244