TROCHE Prescription Repeat Order Form

TROCHE Products Online Order Form
Please be aware that original prescription must be held at the pharmacy or received by prior to release of the product.

Please contact us if you are unsure or new to hormonal troches.

Email (pharmacy@schealthcare.com.au) or use Contact Form (Click Here).

Or call us on (07) 5315 8866.

This Form is only for hormonal troches - for other compounded prescriptions please CLICK HERE.
YES - My original prescription is already on file at the Pharmacy.I will upload a copy of my prescription and will post the original to be received prior to release of the product.I will upload a copy of my prescription and will drop the original into the Pharmacy.I will upload a copy of my eScript QR Code to be dispensed.
File Upload

Cancelof
Reminders
Name*

First NameLast Name
E-mail*
example@example.com
Your Phone Number*
Mobile or Landline
Billing Address*

Street Address

Street Address Line 2

CityState

Post Code
YesNo
Shipping Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Special Instructions Or Comments
Caboolture Compounding Pharmacy

SCHC Pharmacy Pty Ltd Help Line: (07) 5315 8866

My Products

Product Refill

BHRT COMPOUNDED TROCHE Please select preferred flavour (or unflavoured). Please select quantity: 1 (30 units), 2 (60 units), or 3 (90 units). Compounded troche products are stable for 180 days when stored appropriately.

$85.00AUD QuantityFlavoursFlavour Strength
Item subtotal:$0.00AUD

Express Delivery - Australia Post Total Cost $13

Please DESELECT DELIVERY if you are collecting your items from Caboolture Compounding Pharmacy in person. Delivery Cost is $13 (including GST).

$11.82AUD

Subtotal

$0.00AUD

Tax

$0.00AUD

Total

$0.00AUD

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Should be Empty:

TROCHE Products Online Order Form

Caboolture Compounding Pharmacy