Huisartspraktijk Van Willigen

Order your repeat medication below:

Here you can order your repeat medication. Medications ordered before 11.00 AM, can be picked up the next day at your pharmacy. (weekends aside) if you absolutely need your medication the same day, you express this by clicking YES in the urgentbox.

Fill in your details and the required medication and click "Submit the order". Fields marked with (*) are required!

Surname: (*)
Initial(s):
Date of birth: (*)
BSN (Social Security number):
Telephone number: (*)
E-mailadress:
Pharmacy: (*)
Urgent?	Yes No
Required prescription(s):

Medication	Dose	Tab/Caps/Cr/Other	Per day	Total amount

Possible remarks:

If you fill in your e-mail adress, you will receive a copy of your order automatically.