Get a Prescription for Migraines

Step 1 of 5

Name *

First

Last

Date of Birth *

Email *

Address *

Select Pharmacy to where prescriptions should be sent. Select "other" if you can't find your pharmacy *

1. Please share your birth gender? *

2. Is this service for yourself, or for someone else (child/adult) ? *

3. Has a GP diagnosed you with migraines in the past? *

4. Are you looking to receive a prescription for opiates, gapapentin, topiramate or ergotamine? *

5. Was your first episode of a migraine 6 months ago? *