Script Or Referral Request Form

We are pleased to be able to offer you an online repeat prescription and referral request service. There is a charge associated with this service and it is currently $26.00 for non- urgent and $30.00 for urgent requests to cover the costs on-charged to us as well as the time spent by the doctors. The doctors reserve the right to refuse and refund payments for restricted drugs or for medications that require clinical review and these include (and are not just restricted to) narcotics, S8 Scheduled medications, Duromine, Valium etc.

For your convenience your script will be sent to you electronically to your mobile phone number as a token. You can take this token to your chemist to be dispensed.

To request your script or referral please provide your details below: