Repeat Prescriptions

• Please use order form below
• Adults $25 / Under 18 $15 / Under 13 Free
• Fax / Post $5
• Allow 2 working days for your script to be ready.
• There is no need to confirm – we will contact you if needed
• Make payment to 03 0802 0175929 00 and include your name and date of birth.
• Urgent Scripts or Last Consult over 12 months – Please book an appointment instead 

*

• First Name *
• Surname *
• Date of Birth *(dd/mm/yyyy)
• Phone Number *Daytime contact number
• Email *
• Doctor *
  Dr Mark RogersDr Kim LawsonDr Victoria FlightDr Frances Matthews
• Medications Required *
  Please be as detailed as possible
• Pick Up or Fax *
  Pick up items at Cranford Pharmacy (On-Site at ProMed)Pick up script at ProMed ReceptionFax pharmacy ($5):
• Pharmacy Name & Address

 

Verification

• Please enter any two digits *Example: 12
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