Prescription request

This request will be reviewed by a doctor.

Should a face to face appointment be required, we will contact you to make suitable arrangements, otherwise your prescription may be available within 72 hours.

A $15.00 fee is raised for each prescription request.

NB: fields denoted with an asterix are compulsory.

    Personal Information

    Prescription List

    Doctor Information

    Prescription will be collected from (select one):
    ClinicCorner AmcalEastwoodAdvantage PharmacyPaynesvilleWarehouseText to Phone

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