Request a Repeat Prescription

There is a charge for repeat prescriptions of $15 if you pick the prescription up, or $17 if you want us to fax the prescription through. Please allow 48 hours before collection / faxing.

Name:

Email:

Daytime contact number:

Your Doctors Name:

Name of Medication:

Dose and how often you take it:

I will collect the prescription:

Fax my prescription to: (Pharmacy)