Order request

Send a request to the pharmacy. Submission is not an online sale, availability confirmation or dispensing guarantee.

Order request

Sending an order request is not an online sale, availability confirmation, or automatic acceptance of an order or dispensing. The pharmacy team reviews the request subject to product availability and applicable professional and regulatory rules.

No online payment is offered on this website. No cart or automatic order confirmation.
Dispensing of certain medicines requires a valid prescription and the required pharmaceutical check.

Last name *

First name *

Phone *

Email (optional)

City *

Neighbourhood *

Product name *

Dosage

Presentation / pack

Requested quantity *

Message (optional)

Attach a prescription or document useful for reviewing the request

Sending a prescription does not mean automatic validation or automatic dispensing authorisation.

Send only necessary documents. A prescription may contain health data requiring special protection. Privacy policy.

Accepted formats: JPG, JPEG, PNG, WEBP, PDF — max. 10 Mo / fichier (5 max.).

Take a photoSelect a file

Your request will be reviewed by the pharmacy team. It is not an online sale or an automatic confirmation of availability or dispensing. The information is used to process this request. Privacy policy.

By using this service and sending this request, you acknowledge that you have read the Terms of use and the Privacy policy.