Please use this form to request a repeat prescription of medications recently prescribed by your dermatologist.
A prescription fee will routinely apply.
Your name (first and surname)
*
Dermatologist
*
Dr Todd Gunson
Dr Paul Le Grice
Dr Fergus Oliver
Dr Denesh Patel
Dr Chin-Yun Lin
Dr Bob Chan
Email address
*
Delivery method
*
Send directly to a pharmacy
Post to you
Pick up from Remuera Road
Your postal address
Pharmacy name and street address
Prescription items requested and quantities of each
*
Submit
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