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Request for other non-repeat medication
Please only use this form if you are requesting medication that has previously been prescribed for you but is not on repeat for you.
If you've never been prescribed the medication, please use our new medication request form.
We will assess the request and some medication can be prescribed without requiring a phone call. For some medication, we will need to call you to clarify details about how the need for the medication.
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- Please read our Privacy Policy to discover how we protect and manage your submitted data.
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