Order Form

Order Form

  • Distance Supply Form

    In order for us to provide a high level of care to you it is important that we have accurate information about you, including administrative and personal details. We ask that you complete this form and return it to this pharmacy as soon as possible. We may be unable to provide some products or services without this information.
  • Date Format: DD slash MM slash YYYY
  • Patient Details

  • Exactly as it appears on your Medicare Card
  • Date Format: DD slash MM slash YYYY
  • (if applicable eg. Pension Card, Health Care Concession Card, Seniors Card, DVA Card)
  • Current Medicines

  • Eg. Panadol, Paracetamol, 500mg tablets, 2 tablets 4 times a day, 1 January 2018
  • Medical History

  • (if no allergies please write "no known allergies")
  • (eg. Blood pressure, visual impairment, confusion, asthma, diabetes etc.)
  • Accepted file types: jpg, pdf.
  • Note: Unless accurate information of your Medicare Number/s and Expiry dates are provided, subsidised medicine under the Pharmaceutical Benefits Scheme will not be available.





Phone +61 2 9649 4657  |  Fax +61 2 9649 3125  |  Contact Us: Click Here

payment options
QCPP accreditation details: Ramadan Pharmacy. 63 Rawson Street, Auburn, Sydney NSW Australia 2144.
Proprietors: Suzan Meguid, Tamer Abdel-Megeed & Hani Abdel-Megeed. Pharmacist available - Monday to Friday 8:00am to 7:00pm (EST) Saturday 8am to 5pm (EST) & Sunday 10am to 3pm (EST)
**Please note that not all products available online are available in the stores. The RRP against which any savings comparisons we make to the listed sale price for products displayed on this website is: the supplier's recommended retail price for the product, provided that this is a price at or above which at least 5% of Australian Pharmacy Transactions~ have occurred for that product within the previous 2 months; or if at least 5% of Australian Pharmacy Transactions~ for that product in the previous two months did not occur at or above the supplier's recommended retail price, the RRP will be the price at or above which at least 5% of Australian Pharmacy Transactions~ occurred within the last 2 months. All prices displayed on this website are in AUD unless otherwise indicated. Actual product or product packaging delivered may vary slightly from product image shown.

*This product may not be right for you. Always read the label, warnings and instructions for use, before purchase. Vitamin and Mineral supplements should not replace a balanced diet.
Always read the label. Follow directions for use. If symptoms persist talk to your healthcare professional. This medicine may not be right for you. Read the warnings before purchase.
The Pharmacist reserves the right to not supply contrary to our professional and ethical obligation.
Sunscreen is only used for one element of protection.

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