MEDICATION SCREENING TOOL Name * First Name Last Name Email * Preferred Contact Number * Country (###) ### #### So we can provide you with the best of care, please answer the following questions: Have you used this medication before? Yes No Unsure Are you experiencing any unintended side effects that you would like to discuss? Would you like some help from our Pharmacist team regarding your medication(s)? * Yes, I would like a Pharmacist to ring me. No, I am satisfied with my consult so far. Thank you for your time! Our Pharmacist team will now process your medication shortly and provide additional support if required. In the interim, feel free to visit us at Stirling Central Shopping Centre or ring us on 08 6256 1512 for any questions that you may have about your therapy.
