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Prescription orders

Stay healthy

We're happy to help!

Dear patients,

to make ordering repeat prescriptions as convenient as possible
To make this possible, we offer you the opportunity below
Order your desired repeat prescription online.

To order your repeat prescription, please fill out the form below. Your chip card must already be registered for the current quarter in order to order a repeat prescription.

Your information will be treated with absolute confidentiality.

Privately insured?:

You can pick up the prescription from us or have it sent to you.

Legally insured?:

We create an e-prescription for you. You can collect/order your medication from the pharmacy of your choice on the next working day.

First name

Last name

phone

E-Mail

Geburtsdatum

E-Mail repetition

Medication 1

Potency

Medication 2

Potency

Medication 3

Potency

Your message

Data protection

I agree to the data processing.*
The information from the contact form will be collected and processed.

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