Demande d'ordonnance

Vos demandes d’ordonnances

Désormais, vos ordonnances sont directement lisibles avec votre carte d’identité dans n’importe quelle pharmacie.

Les médecins du Centre de Santé de l’Amblève s’engage à faire l’ordonnance demandée dans un délai de 48 heures maximum. Après ce délai, votre demande, présentez-vous chez votre pharmacien avec votre carte d’identité pour récupérer les médicaments prescrits. Nous vous remercions de regrouper vos demandes de prescriptions.

Cette procédure concerne uniquement le renouvellement de vos médicaments habituels. Pour toute nouvelle demande, merci de prendre rendez-vous avec votre médecin.

Ce service est réservé aux patients inscrits à la maison médicale.

Remplissez ce formulaire pour obtenir une ordonnance.

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Choisissez votre médecin traitant

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Nombre de médicament(s) souhaité(s)

Médicament(s) souhaité(s)

Nom du médicament *

Dosage *

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Médicament 2 - Nom du médicament

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Médicament 3 - Nom du médicament

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Médicament 4 - Nom du médicament

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Médicament 5 - Nom du médicament

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Médicament 6 - Nom du médicament

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Médicament 7 - Nom du médicament

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Médicament 8 - Nom du médicament

Dosage

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Le Centre de Santé de l’Amblève est une équipe pluridisciplinaire qui fournit des soins de santé primaires au cœur d’Aywaille.

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