Upload Script - My Skin Compounding Pharmacy

ORDER YOUR PRESCRIPTION

Please note this form is for reordering products from a previous consult only. If you want a review consultation please book here.

THIS FORM IS BEING SUBMITTED BY A PRACTITIONER

Clinic Name(Required)

Clinic Email(Required)

Clinic Phone Number(Required)

Person In Charge Of Payment(Required)

Clinic (we will call clinic phone number above)

Patient (we will call patient phone number below)

Prescription Type(Required)

New Prescription

My Skin Pharmacy Refills

External Pharmacy Refills

Skin/Hair/Hormone Consult Product Refills

Item(s) required, Previous Prescription Number (if known)

Delivery Option

Your Name(Required)

Your Phone(Required)

Your Email Address(Required)

Address

Address Suburb State Postcode

File

(For eScripts, please upload a screenshot of the QR Code or Barcode with the 18-digit alpha-numeric code)

Drop files here or

Max. file size: 3 GB.

Message:

To comply with Pharmacy Regulations, please supply the original copy of the script via post within 7 business days to My Skin Pharmacy – Shop 1, 530 Milton Road, Toowong QLD 4066. If your script is an eScript, we do not require the original copy to be posted.
We will contact you as soon as we receive your script.

Our staff will contact you by telephone to finalise payment.
We use Australia Post Express. Please see the shipping price schedule for more information.

Our staff will contact you by telephone to confirm your order, payment and shipping options.
Shipping: Please see the shipping price schedule for more information.

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