Contact

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.
Upon submission your request may take up to five working days to be ready and will be send directly to your phone or email.
All script requests will incur a charge that will need to be payable at your next visit or over the phone.
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 will be sent electronically to phone or email. If this information is not provided the script will not be sent. *

Medication One *

Medication Two *

Please complete the below: *

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

Submit