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Quit Smoking Consultation Enquiry

    1 Personal Details
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    Please include all 10 Numbers
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    The reference number (single digit) can be found in front of your Full Name on your Medicare Card.

    2 Medical history
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    3 Smoking history
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    Your personal information will only be used for the purposes for which it was collected or as otherwise permitted by law, and we respect your right to determine how your information is used or disclosed. .By signing below, you are consenting to the collection of your personal information, and that it may be used or disclosed by the practice as per our Privacy Policy. I have read the information above and understand the reasons why my information must be collected, and the purposes for which my information may be used or disclosed.

    SIMPLE STEPS

    Consultation Process

    1

    Consultation Enquiry

    Enquire for consultation. Start your journey to better health. It’s that simple

    2 Consultation Enquiry

    Order Your Prescription

    Order medical products at our pharmacy

    3

    Pickup or Delivery

    Flexible delivery options available for your convenience

    REPEATS MADE EASY

    Would You Like to Organise Your Prescription?