Please Complete the CBD Script To Your Own Pharmacy Below

 

"*" indicates required fields

Patient's Name*

Own Pharmacy Details

Pharmacy Name*

Products Prescribed (if known)

CBD Oil Product (Prescribed)*
Have you confirmed that this product is available at your preferred pharmacy?*

Patient's Declaration & Consent

1) It will take 1-3 business days for your script to be processed by our clinical team and sent to your chosen pharmacy. 2) You may need to book a follow-up appointment to get further repeats.
Patient's Declaration*
To the best of my knowledge, the information that I have supplied is complete and correct.