Order Your Script
(Existing Patients)

Select an option *

New script

Filling repeat

Have you used this medication before?

Only applicable to new scripts

Yes

No

Name *

First Name

Last Name

Are you pregnant or breastfeeding?

Pregnant

Breastfeeding

N/A

Collection *

Pick up

Delivery (additional fees apply)

Keep repeat on file at pharmacy?

Yes please

No thanks