Prescriptions This service is for existing patients of the practice who would like to renew their regular prescriptions. There is no Medicare rebate for this service. It is not suitable for opiate medications (such as oxycodone or codeine), sleeping tablets, benzodiazapines or antibioticsAre you an existing patient of the practice?*YesNoHave you had this medication from this clinic before?*YesNoHave you had an appointment at the clinic within the last 12 months?*YesNoThe dose or strength of my medication has not changed in the last 6 months (or since last visit)?*YesNoIf NO to any of these then not suitable for an online repeat request – Please book an appointment at the clinic Name* Patient first name Patient surname Phone*Email How many different medications required?Please enter a number less than or equal to 3.1. Name of medication* 1. Strength* 1. Dose* 2. Name of medication* 2. Strength* 2. Dose* 3. Name of medication* 3. Strength* 3. Dose* eScript to your mobile phone (preferred) or fax to the pharmacy or post?*eScript to my Mobile PhoneStandard PostFax to PharmacyPlease enter which pharmacy to fax this to We need the name and address of the pharmacy pleaseAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Prescription* Price: Prescriptions will be processed Monday- Friday. They will be faxed or posted on the day of the order if placed by 6pm. Please allow 3 business days for posted scripts to arrive.CommentsThis field is for validation purposes and should be left unchanged.