PRESCRIPTION REQUESTS

Repeat Prescription Request

Name: Birkdale Medical
Address: 120 Birkdale Road, Birkdale, QLD, 4159, AU
Telephone: (07) 3207 4600
Price range: AUD

You must answer YES to ALL questions.

Repeat Prescription Request

Have you attended at Birkdale Medical during the last 12 months?:

Have you received a prescription for this medication from Birkdale Medical previously?:

Are you requesting a maximum of two scripts?:

Are you aware that the following medications cannot be requested via email: antibiotics; benzodiazepines eg diazepam, sleeping tablet eg temazepam, strong opioid painkiller eg oxycodone?:

Are you aware that the following medications are only available as a 1 MONTH EMERGENCY supply: blood pressure, heart, or diabetic medication?:

Please provide name and dosage/strength of the requested medications (Max 2):

Who is your regular Doctor?:

Do you accept the charge of $20:

Name of Patient:

Email:

Phone:

Date of Birth:

Please Note:

Please allow up to 48 hours for your request to be processed during business hours.

Please note, if the doctor is able to process your script request, it will be sent as an eScript to your mobile phone. Once you receive your eScript token, please call reception to arrange payment.

Contact Info

Phone: (07) 3207 4600

Fax: (07) 3207 4800

Address: 120 Birkdale Road, Birkdale, QLD 4159 Australia

Business Hours

Monday to Friday 7:30 am - 6:00 pm

Saturday 8am - 1pm

Repeat Prescription Request

Repeat Prescription Request

Contact Info

Site Info

Business Hours