E-Prescription Online

After filling out the form, the doctor will conduct a consultation and decide whether to issue an e-prescription based on medical indications.

Prescription issuance conditions:
- We issue prescriptions without additional documentation for all medicines except for those affecting the central nervous system, antidepressants, sedatives (anxiolytics), psychotropic drugs, anticonvulsants, medicines containing narcotic and opioid substances, antiepileptic drugs, neuroleptics, and medicines intended for the treatment of oncological diseases and potency;
- WE DO NOT ISSUE PRESCRIPTIONS FOR ABORTION.
- If you order a prescription for the above-mentioned medicine and do not provide documents confirming the diagnosis from a specialist doctor, and the order is received without documentation, the E-Prescription will not be issued. This is equivalent to the inability to refund!

* Questions marked with a red asterisk must be answered.

* Medicine Selection

I want to choose from the list of medications

I will manually enter the name of the medication, as well as the dosages and the number of packages (no more than 2 packages for 2 different medications)

Patient Data

*First Name

*Last Name

*E-mail

*Phone

Phone

*Street

*House

*City

*Postal Code

*PESEL Number

Select all

I accept the Terms and Conditions for issuing prescriptions and sick leaves and the Privacy Policy of the website. The information I have provided is accurate. I use the service on my own behalf and of my own free will.

I declare that I am aware that after filling out the form, the doctor will contact me by phone for a remote consultation.

I declare that I have been informed that entering into an agreement for a telemedicine service does not guarantee the expected benefits. After analyzing the questionnaire and a phone consultation, the doctor will decide whether to issue or refuse to issue an electronic prescription, as well as determine the quantity and dosage of prescribed medications.

I declare that I am informed that in the case of ordering a prescription for antidepressants, psychoactive, oncological, and other prohibited drugs without providing supporting documentation from a doctor, the prescription will not be issued, the service will be considered completed, and a refund will not be possible.

E-Prescription Online

Prescription issuance conditions:

* Medicine Selection

Medical Interview

Patient Data