Send us your medical prescription

First name

Last name

E-mail

Date of birth

Phone number

At least one of the two fields below must be filled in for your request to be validated.

By submitting the form, you declare that you have read and accept the privacy policy and the general terms of use. In particular, we will process personal data in the context of the remote ordering system.

I have read and agree to the privacy policy and terms of use.

Thank you for sending us your order, we will notify you by e-mail or telephone or SMS to invite you to come and collect it from our pharmacy