Get Started - The Health Assurance Plan

Get Started

The Health Assurance Plan

Complete this short form so our pharmacists can help you secure your prescriptions, supplements, or cosmetics through the Health Assurance Plan. It only takes a minute.

Are you or your family currently on any long-term medication? *

Yes

No

Do you often struggle to find your medication at nearby pharmacies? *

Yes, a lot

Sometimes

Rarely

Never

Are you available to talk to a doctor within the next 10 to 30 minutes? *

Yes

No

What time of day works best for your consultation?

Morning (9am - 10am)

Afternoon (1pm - 2pm)

Evening (7pm - 8pm)

Full Name *

Phone Number *

Would you like the doctor to know something before they call you?

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