PRESCRIPTION ORDERING Script Order Online script order form Your Name (required)* First Last Do you have any allergies or sensitivities? (required)* Yes No Please briefly listNoneStreet Address (required)* Street Address Address Line 2 Suburb State Post Code Contact number (required)*Email address (required)**Please note, @yahoo.com and @yahoo.com.au email address are incompatible with this system and will not be received by the pharmacy. Please use a different account or call the store to ensure your order is received. Enter Email Confirm Email Items to Order (required)*Please briefly, but descriptively (including strength and quantity) list all required items. Unclear orders may be delayed. Do you want to take the pharmacy preferred (generic) brands? (required)* Yes No Only if original brands are unavailable Please note that at the moment, generic brands are far more readily available than original brands. If you elect not to take generic brands and the original brand is unavailable, your order will be cancelled. Are your script(s) on file, attached below or being faxed from your Doctor? (required)* On File Attached Being Faxed Do you want us to file your repeats for easier ordering in the future? (required)* No Yes How would you like to receive your script? (required)* In-Store Pickup Delivery (next working day) Please note that we can only deliver to houses in the 4152 and 4151 postcodes and we cannot deliver to PO Boxes.Special instructionsDO NOT INCLUDE CREDIT CARD DETAILS. We will call to obtain card details for payment in advance if required. Upload a copy of your script. Please make sure that your image is legible and of a reasonable size. Unreadable scripts may result in a delay in your order. Please note that you legally must provide the original copy of the script to the pharmacy. Drop files here or Select files Max. file size: 8 MB. Maximum file size 6MBCAPTCHA
