Request a Repeat Script

If your child has been assigned a medication and script by Dr Fourie and you require a repeat script, please fill in the fields presented here to send us a request.

Please allow for 24 hours for your request to be processed.

Patient name

First Name

Last Name

Parent/caretaker name

First Name

Last Name

Contact number

Email

Date of Birth (of patient)

Medication (Name, dosage, frequency)

Please label the different medications with a bulletpoint and remember to add the correct dosage amount.

Please note that we cannot, by regulation, provide you with a script if Dr Fourie has not seen the patient within 1 year. Please schedule an appointment if that is the case and you wish to continue the medication.

I understand.

Before you go, does your child have ADD/ADHD or another form of neurodiversity?

We’re working on a simple, trusted app to help parents screen for early signs of ADHD/ADD/neurodiversity — from home, before visiting a specialist.

If there was an app you could use to pre-screen your child for ADHD/ADD (at the cost of R20) would you have used it?

Request a Repeat Script

Before you go, does your child have ADD/ADHD or another form of neurodiversity?

Making Children Better.

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