
Compounding patient assessment form
A VALID PRESCRIPTION IS REQUIRED FROM YOUR DOCTOR.
This medication will be compounded specifically for you as there isn’t a commercially available TGA (Therapeutic Goods Administration) registered product.
A VALID PRESCRIPTION IS REQUIRED FROM YOUR DOCTOR
Thank you for taking the time to fill out our assessment form.
As a part of our Standard Operating Procedures, we require this information to assess the best options for your compounded medication so we can provide a product that is best suited to your individual needs.
You may receive a phone call from our compounding pharmacist if further clarification is needed.
Please Note:
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Please allow 2-4 days for delivery of your prescription by
For any enquiries or additional information please contact us at info@mckenzieschemist.com.au or call us on (08) 9272 8726 during operating hours.