Prescription Request Form

  1. Once the prescription request form is completed, your doctor will advise within 5-10 business days whether a consultation is necessary before prescribing the medication.
  2. If a consultation is not required, your doctor will prepare your prescription within approximately 5-10 business days. A prescription fee of $50 applies, with a maximum fee of $70 for multiple prescriptions.
  3. If your child requires a government-regulated medicine and your current doctor is unavailable, a full initial consultation with another doctor is required (Medicare regulations).

 

Please note that ADHD medications require ongoing clinical monitoring and review. In line with Australian best-practice guidelines and prescribing requirements, patients are generally expected to be reviewed at least every 6–12 months whilst receiving ongoing stimulant prescriptions.

Where a patient has not been reviewed for an extended period (particularly >12 months), we are unable to provide further prescriptions until a follow-up appointment has occurred.

In some circumstances, a short bridging prescription may be provided at the discretion of the treating clinician where a review appointment has already been scheduled. This is assessed on a case-by-case basis and cannot be guaranteed.

We strongly encourage families to book routine reviews in advance to avoid interruptions to treatment.

Agreement to Prescription Request form information.

Patient Details

Patient's Date of Birth
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Patient Registration

Patient Details

Date of Birth

Address

Parent / Guardian (Primary Contact)

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

Referring Doctor Details

Your payment details are stored securely to facilitate efficient billing for future services, including Telehealth consultations, prescription requests, and medical reports.  A $0.50 verification charge will be applied to your nominated card to confirm the payment method. In accordance with our Appointments and Fees Policy, full payment is required on the day of service. For Telehealth, payments are processed in advance to secure your booking. See Appointment and Fees Policy

Consent

At Brighton Health Clinic for Kids, we believe clear and respectful communication is essential to your child's health and wellbeing. We value your trust and work closely with families when making decisions about care and information sharing. To provide the best possible care, relevant information may be requested or shared with other professionals involved in your child’s health, development, or education.

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