Prescription Order Form

Are you a practitioner or a patient and would like your script to be processed efficiently?

Please fill out the form below for our team to start the process of compounding your medicine. For enquiries, please submit through the Contact Us form or email This email address is being protected from spambots. You need JavaScript enabled to view it..

Prescription Details
Patient's Details
Delivery Details
Prescription Orders

Note: Accepted file formats are jpg, png and gif. Maximum file size is 1MB.

Payment Details

We will call to let you know the price, the time it will take to compound and how long it will take to deliver to you via Australia Post.


Need help? Call us direct on 03-8900 4989 between 9.00am-5.00pm EST Monday-Friday (Excluding Public Holidays)

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