Compass Immunology Clinic – Script renewal and Action Plan requests Step 1 of 3 0% Important Information Compass Immunology Clinic is pleased to offer our patients the convenience of ordering your repeat prescription medication or Action Plan via our website or clinic App. You will need to be an existing patient of the clinic and have been prescribed the medication previously by this clinic to use the service. This service does not apply to certain medications and cannot be used for most pain medications, sleeping tablets or sedatives, and some PBS authority prescription items (for example when clinical assessment of ongoing benefit is required.) Our online ordering system may take between 1-7 working days to complete an E-script. Posting scripts will take longer. If you require your medication script in a shorter time frame, please see your GP. Personal InformationFirst Name* Last Name* DOB*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email* Phone*Patient's current body weight* Script/Referral Information Doctor*Select DoctorDr David Heyworth-SmithDr Kathryn HeyworthDr Susan PerelDr Carl KennedyDr Kim RobertsonDr Zi TanDr Andrew MerryDr Marius BothaDr Marion ThomasDr Venetia WhiteheadDr Sophie WillcocksDr Katharine FosterDr Babu PhilipRequest type* Script renewal Allergy action plan Service Fee* Price: Script details*Enter the details of your requested prescription medication or referral request below. Ensure all details are correct before submitting.Current body weight* Preferred antihistamine*CetirizineDesloratadineFexofenadineLoratadineCollection method* eScript (for Scripts) Email (for Action Plans) If you choose to have your script directly to your phone, the mobile phone on file at the clinic will be used.If you require a paper prescription or paper Action Plan, please make an appointment with your doctor.Mail Out Fee Price: Payment Information Billing Address* Street Address Address Line 2 Suburb State Post Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Payment Methods* Credit Card PayPal Credit Card* MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Security Code Cardholder Name Total Cost $ 0.00 Terms and Conditions By clicking submit, you are agreeing that the details you have entered are true, accurate and correct. You confirm that you are an existing patient of Compass Immunology Clinic or Compass Kids Clinic. Scripts and referrals requested via our online ordering system may take between 1-7 working days to be returned to you. If you require delivery in a shorter timeframe, please book an appointment with your regular doctor or GP. There is a charge associated with this service. This charge covers the time spent by our administrative staff & doctors to prepare your request. The clinic reserves the right to refuse any request they deem inappropriate. In such circumstances, your fee will be reimbursed immediately, and the clinic may contact you to follow up. Please note if you have chosen to pay via PayPal you will be directed to the PayPal site to confirm payment after you click the 'accept' button below.Acceptance of Terms & Conditions* Yes I accept