Submit a Script

Orders for Collection:
Your order will be ready within 2 hours. Please remember to bring your original prescription when you come to collect your order.

Orders for Delivery:
Your order will be delivered within 48 hours.

Submit a prescription service hours:
Monday – Friday: 09:00 – 20:00
Saturday: 09:00 to 20:00
Sunday: 09:00 – 18:00

For legal reasons we are unfortunately unable to dispense any Schedule 6 medicines via this service.

Name and Surname

Email Address

Phone

Date of Birth

Medical Aid

Prescription Information

Can we replace with generics?YesNo

List Of Allergies (Comma separated)

Is this script for chronic or repeated medication?Yes, its repeat medication.No, its once off medication

Shipping MethodCollect from storeDeliver my medication (Within 30KM radius)

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Payment TypeCash or Credit CardMedical Aid

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Submit a Script

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