• Compounded Prescription Order Form

    Compounded Prescription Order Form

    To order your prescription, complete the order form below

  •  Compounded Prescription Order Form​
    Welcome to the Slade Pharmacy Online Compounding Order Form. ​
    ​
    IMPORTANT: Compounded medications are custom-made for each patient and typically take two business days to prepare. For more information, please review our FAQs.​

     We will notify you via email or SMS when your medication is ready for pick-up or shipping. ​

     

    Medication Updates - June 2026

    Atropine 0.01%, 0.025% and 0.05% Eye Drops are now available as a new off the shelf product Eikance

    If we currently hold your script for Atropine 0.01%, 0.025% or 0.05% Eye drops, please contact us directly on 

    • PH: 03 8420 0700
    • E: orders.richmond@slade.net.au

    If you would like to order Atropine eye drops, please contact us directly via phone PH: 03 8420 0700

     

     

    Prostin is available as an off the shelf product Caverject © in a 10mcg and 20mcg Syringe.


    Prescription requirement​
    By law, we must receive the original paper prescription before supplying your medication. Please ensure your prescription is mailed or handed in as needed.​
    ​
    If you have any questions, please contact our team at 03 8420 0700 or email orders.richmond@slade.net.au 

  • *Please note*

    Atropine 0.01%, 0.025% and 0.05% Eye Drops are now available as a new off the shelf product Eikance

    Prostin is available as an off the shelf product Caverject © in a 10mcg and 20mcg Syringe.

    Please visit your local Slade Pharmacy for supply or email your prescription to orders.richmond@slade.net.au and one of our team will contact you within one business day.

  • Compounded Prescription Order Form

    Compounded Prescription Order Form

    To order your prescription, complete the order form below
  • Format: 0000 000 000.
  • Date of birth*
     / /
  • Gender*
  • Are you pregnant or breastfeeding?*

  • Compounded Prescription Order Form

  • Do you (or they) have any allergies, sensitivities or intolerances?*
  • Do you regularly take any other medications?*
  • Have you used this medication before*

  • Your Prescription

    To dispense medication, a valid prescription issued by an authorised healthcare practitioner in Australia is required. Please note that prescriptions are valid for a maximum of 12 months from the date of issue
  • Does the pharmacy have your original (ie paper) prescription?*
  • Would you like us to keep your repeats on file?*
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof

  • Delivery Details

    Let us know if you would like pickup your script or have it mailed to you.
  • Delivery*
  • Date of collection at site?*
     / /
  • Date of dispatch?*
     / /
  • Dispatch Acknowledgement*

  • Frankston/Geelong/Werribee Orders takes an extra day to deliver and no orders are sent on Friday. Hence if you select Monday delivery, these orders will only be availalbe for collection on Tuesday. If you require your medication sooner please select another site for collection. 

  • Prescription Payment

    Select your drug to calculate the cost

  • Atropine Eye Drops

    Contains Benzalkonium Chloride 0.01% as a preservative. The eye drops has a 60 days expiry once made and 28 days in-use expiry once opened. Please pick up as soon as you are contacted to ensure you receive the maximum length of expiry. 

  • Atropine Preservative Free Eye Drops:

    Does not contain any preservatives, used for patients with sensitive eyes. Supplied in 4x 3mL bottles sufficient for ONE month supply. Each 3mL bottle has a 7 day in-use expiry once opened. 

  • Slade Pharmacy ED Products:

    Promix Regular, Promix Mega and Promix Ultra contain alprostadil, papaverine and phentolamine in different combinations in a 6mL multi-dose vial.

    Prostin (all strength) contains alprostadil only in a 10mL multi-dose vial.

    Slade Trimix Regular and Slade Trimix Extra contain atropine, papaverine and phentolamine in different combinations in a multi-dose vial.

    All Slade Pharmacy ED products contain benzyl alcohol as a preservative. All vials have a minimum 28 day expiry at dispensing. 

    If you are unsure which product you need to order, please e-mail a copy of your prescription to orders.richmond@slade.net.au along with your contact details and one of our team will be able to help you decipher your prescription.

  • Do you need any of the following? (Select all that applies)

  • Error with shipping calculation. Please click Refresh button above.

  • Total Due

    prevnext( X )
      AUD

    • Please ensure all details are correct before you submit. 

    • Pay with PayPal

      Choose from one of the PayPal options to make your payment.

    • Should be Empty: