Prescription requests

1Accept Conditions

2Personal Details

3Medication Details

4Delivery Details

5Payment

Use this form to request repeat prescriptions for medications that have been prescribed by Dr Cunnington, Dr Khoo or Dr Hatch within the last 12 months.
In many cases, your GP will be able to provide prescriptions for you. Your GP receives a letter after each appointment outlining what medications, including dosages, you have been prescribed.
There is a nominal cost of $30 for repeat prescriptions to cover the time taken and administrative costs of writing and issuing prescriptions outside of consultations.

NOTE – As of April 1st 2022, legislation in Victoria does not allow electronic copies of prescriptions to be emailed or faxed to pharmacies. Scripts will be issued as printed paper scripts and can be sent via mail or collected from Melbourne Sleep Disorders Centre (Suite 508, 100 Victoria Pde, East Melbourne) during business hours (9am-5pm, Mon – Fri)

Before you enter details, please read and agree to the Terms and Conditions
This service is only available for existing patients who have been seen in the last 12 months. If you haven’t been seen in the last 12 months, you will need to make an appointment to be reviewed clinically to ensure the medication is still appropriate for you.
We can only provide repeat prescriptions for medications started and prescribed by Dr Cunnington, Dr Khoo or Dr Hatch. To obtain a repeat prescription, you must have obtained this prescription from us within the last 12 months.
You may select more than one medication, up to three, with each request.
Each prescription request is assessed by your doctor who will approve or decline the request on clinical grounds. If the request is declined, you will be advised why and your payment refunded.
The fee ($30) is payable when the request is submitted. If your request is declined, you will receive a full refund within several business days. Payments are managed securely via Stripe.
Scripts will be issued within five (5) working days from submission of the request. Many of the medications prescribed require permits and checking of online databases that track prescriptions and usage so aren’t able to be issued urgently or at short notice.
Delivery via mail may take up to five (5) business days to arrive from the date posted.
Electronic versions of printed prescriptions sent to patients via email are not legal prescriptions, hence we cannot email prescriptions directly to you.

These details are needed to match you to your clinical records. We will use your email address to communicate with you about your request.
First Name*
Last Name*
Email*
Date of Birth*

Day
Month
Year

(1) Name of Medication
(1) Tablet / Capsule Strength
- Add a second Medication...
(2) Name of Medication
(2) Tablet / Capsule Strength
- Add a third Medication
(3) Name of Medication
(3) Tablet / Capsule Strength

Mail or Pick up
- Mail (allow at least 5 working days)
- I will pick up from the practice
You will receive an SMS once you script is ready to collect from: Melbourne Sleep Disorders Centre Suite 508, 100 Victoria Parade East Melbourne VIC 3002 Between the hours of 9:00am - 5:00pm, Monday to Friday
Address to post script to:*
Street Address Address Line 2 Town / Suburb State Postcode

Script
Price:
Transactions are securely handled by Stripe. You will receive an email with a receipt on payment.
Credit Card
Card Details
Cardholder Name

Prescription requests

Before you enter details, please read and agree to the Terms and Conditions