Script Enquiry

Please complete this form only if your enquiry relates to your current medication or a recent prescription.

If you need a new script, please book an appointment with your GP.

If your medication was prescribed in the last 6 months and is due for renewal, or if you have lost or damaged your script, you may be eligible to request a repeat script without an appointment. A $35 administration fee applies for this service. You can request a repeat script here.

Please note that all new scripts require an appointment with your GP, as do repeat scripts for drugs of addiction and medications prescribed more than 6 months ago.

Please allow up to 3-5 business days for us to respond to your script enquiry.

PATIENT DETAILS

Date of Submission

First Name *

Last Name *

Date of Birth *

Contact Phone Number *

Email Verification *

Send code

ENQUIRY DETAILS

What does your enquiry relate to? *

Please provide us with some more information about your enquiry

What is the name of your current medication *

On which date did you receive your script from your GP *

Signature *

Clear

Date *