Prescription order

Information leaflet on ordering prescriptions

Processing time:

Inquiries regarding the processing status:

Please refrain from further inquiries regarding the processing status within the processing time of 5-7 working days.

Validity of PDF formats:

Submission of order forms:

Only prescription orders submitted via a completed order form will be accepted, either by email or post. Alternatively, you are welcome to fill out the form legibly by hand and send it to us by post.

Completeness and correctness:

Please note that we can only process order forms that are fully and correctly completed. If any fields are not required, please enter a placeholder (e.g., - / . / x).
Prescription orders without confirmation cannot be processed. Please ensure you provide all required information.

reCAPTCHA:

Confirmation:

If the field contains the message "Your message has been sent"The "" icon appears, indicating that the prescription order has been successfully transmitted.

Prescriptions are sent exclusively by post. Unfortunately, e-prescriptions cannot be issued.

Name first Name

Current date

Feedback on the previous type 1 (name/ quantity prescribed/ brief feedback)

Feedback on the previous type 2 (name/ quantity prescribed/ brief feedback)

Feedback on the previous type 3 (name/ quantity prescribed/ brief feedback)

Did you experience any side effects?

If so, which ones?

Your current symptoms:

Complaint scale 0-10

Description of appetite:

Your current sleep quality:

Scale 0 - 10

Daily consumption of variety 1 in g or ml

Daily consumption of variety 2 in g or ml

Daily consumption of variety 3 in g or ml

Next strain for effect comparison [morning] (manufacturer/ strain/ THC/ quantity)

Next strain for effect comparison [Midday] (Manufacturer/ Strain/ THC/ Quantity)

Next strain for effect comparison [evening] (manufacturer/ strain/ THC/ quantity)

Telephone:

E-mail

Pharmacy Information / Name

Pharmacy Address