Contact Form - Secure Online Payment (Polipay) for Script Form (#6) (#12)

Secure Online Payment (Polipay)


Use this form to prepay securely online via Polipay direct from your bank account, to facilitate prescription handling. 

See supported banks

Else prepay the appropriate prescription fee to our bank account (Westpac 03-0162-0098557-000) or via telephone payment (call or email), to facilitate prescription handling.