Select prescription type NewRepeat If repeat, enter prescription number (found on label to the left of the price) Which Fresh Therapeutics Pharmacy do you want to compound/dispense the prescription? BroadwayBondi First Name Last Name Home Address Suburb Postcode Delivery Address (if different from home address) Delivery Suburb Delivery Postcode Email Address Telephone Number (best number to contact you during business hours) If troche/mixture/ suspension please choose a flavor AppleApricotBananaBubblegumButterscotchCaramelChocolateGrapeLemonMarshmellowOrangePeachPeppermintRaspberrySpearmintStrawberryTropicalVanilla PAYMENT DETAILS: Please indicate the best time (during business hours) for us to call to obtain credit card details for payment. Time for phone call (AM/PM) We will call to let you know the price, the time it will take to compound and how long it should take to be delivered by Express Post. Delivery Options Pick up Fresh Therapeutics BroadwayPick up Fresh Therapeutics BondiNationwide Express Post $12 Upload Prescription (Ex: doc, jpg, jpeg, txt, pdf) Your prescription will not be encrypted and will be emailed to Fresh Therapeutics. If you are concerned about security of your prescription please Fax your prescription with a completed copy of the Prescription Order Form (click to open PDF of the order form) to either Broadway 02 92 816 862, Bondi 02 9389 5166 *IMPORTANT: We attempt to make each compound on the day we receive the order. However we cannot send the item until we have received the original prescription. This is a legal requirement. Send the original prescription by Reply Paid Post to: Fresh Therapeutics Compounding Pharmacy Reply Paid 168 BROADWAY NSW 2007 Thank you for choosing Fresh Therapeutics Compounding Pharmacy Need help? Call us on 02 92 816 816
