Pickup or Faxed to Pharmacy
* $19.50 for 14+yrs
* Free for under 14yrs

Please make ALL payments to ASB 12-3476-0015340-00 and use your Name and Date of Birth or NHI as reference.
For more information, please refer to our repeat prescription guidelines.

Please make sure you fill in all required (*) fields

First Name *
Last Name *
Middle Name(s)
Birth Date *
Your Email Address
Phone Number *
Fax to Pharmacy *

To Fax to ANY OTHER Pharmacy, please call 0800 175 175 and choose the first option to speak to Reception