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Request a Script

Terms & Conditions

For Urgent scripts – please call our reception staff on 9921 4433
Restricted drugs will not be prescribed via this service and may require a visit to your doctor.
Once you have submitted your request it will take two working days for your script to be ready for pick up from our reception.
All script requests will incur a charge that will need to be payable on collection.
This services is for prescriptions that your doctor at City Health has previously prescribed to you, it is not for new prescriptions, a change of medication or new patients to the practice.

Please Complete

* Indicates required field

Name *

First

Last

Date of Birth *

Phone Number *

Email *

Your doctors name *

Scripts can be sent to your Pharmacy of choice, please specify or can be picked up at City Health. Payment can be made via telephone or at City Health. *

Medication One *

Medication Two *

Medication Three *

Please complete the below: *

Yes, I have read the Terms & Conditions Yes, I am a current patient of City Health Geraldton.

Submit

​Request a Script

Request a Script