Get PrEP today. Complete this request form to Get PrEP!
Name(Required)
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First and Last name, as per Medicare card or Passport!
Login Password(Required)
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Login Date Of Birth(Required) Please enter to continue.
You must be over 16 to use PrEP Health to obtain PrEP.
Address For compliance we need your address to prescribe you.
Address(Required)
Gender/Sex as per Medicare(Required) Gender with Medicare, if not updated, needs to match so that eScripts and Medicare reconciliation works. We are inclusive and this service is for everyone. However, the nature of the medical referral process requires us to adhere to certain healthcare language guidelines that may not suit you. We hope you understand. We are doing our best and we want you to feel welcome here.
Gender/Sex(Required) How do you identify?
Consultation Do you have Medicare?(Required) If applicable, as the patient, you agree to the assignment of any Medicare Benefit directly to the health professional (ie. Bulk-Billing).(Required) If you need a telephone consult for a postive result or to discuss your results, or your prescription, you agree to assign the Medicare benefit to the doctor supporting you.
PrEP Health bulk-bills telephone consults when they are required, all other services fees are upfront.
Are you new to PrEP Health?(Required) If you are new to PrEP Health you will need to book a telephone appointment. You can do this after you complete this form.
Have you had a telephone appointment with your PrEP Health doctor in the last 12 months?(Required) If, in the last 12 months, you haven't yet had your telephone appointment, with your PrEP Health doctor. You can do that after this form.
Would you like to get your PrEP delivered? Note, we send you an eScript either way. But if you pay for deliver you must not use eScript.
Individual Healthcare Identifier (IHI) number(Required) You will need an IHI number to receive your prescription. If you don't have one yet, we will send you information on how to get it afterwards.
After you complete the form, please follow the links for getting an IHI number to facilitate an eScript. https://prep.health/no-medicare
Telephone appointment Every PrEP Health patient needs an annual telephone appointment.
Telephone appointment without medicare(Required) Telephone appointments are available 6 days a week. You will be able to book an appointment after this submission.
Telephone appointment(Required) Telephone appointments are available 6 days a week. You will be able to book an appointment after this submission.
Consultation options. PrEP Health offers the option for consultations with telephone appointments. The telephone appointments can be bulk-billed (if you have medicare) or claimed with insurance (OSHC for example).
Medicare Appointment Option(Required) You can choose between having an appointment before each prescription, or you can pay for the doctor to review your results, prescribe your PrEP.
No Medicare Appointment Option(Required) You can choose between having an appointment before each prescription, or you can pay for the doctor to review your results, prescribe your PrEP.
Online PrEP evaluation Complete the following form. This is the first step to getting PrEP in Australia.
Are you pregnant?(Required) If you are pregnant, or suspect you are pregnant, trying to become pregnant, etcetera, you need to speak to your regular doctor about PrEP.
If you are pregnant or planning a pregnancy, please don't proceed with our service. Go and see your regular doctor in person.
Do you have sex with other males and/or transgender people? We are inclusive and this service is for everyone. However, the nature of the medical referral process requires us to adhere to certain healthcare language guidelines that may not suit you. We hope you understand. We are doing our best and we want you to feel welcome here.
Do you identify as Aboriginal and/or Torres Strait Islander?(Required) If you are of First Nations, you may be able to access PrEP under the "Closing the Gap" program. This response may also indicate for additional testing.
This question must be answered
Are you, or have you ever been a sex worker? This response may indicate risk for additional testing.
Do you or have you previously injected drugs? This determines if you need HEP C screening on your pathology referral.
Have you ever been diagnosed with syphilis?(Required) This doesn't impact on being prescribed PrEP.
When were you diagnosed with syphilis?(Required) This question must be answered
Medicare details We need your valid Medicare Card to facilitate the service.
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Select a doctor This doctor will be on your referral to receive the results. All of our PrEP Health doctors are amongst the best sexual health General Practitioners in Australia.
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Please select doctor for referral. This doctor will be on your pathology referral to receive results. Please select a doctor with the schedule and time that you prefer if you need an appointment.
Medication Delivery If you pay upfront for the Medication delivery it will be posted the next business day after you receive your eScript.
Do you have a health concession card.(Required) A centrelink health concession card or closing the gap.
DO NOT USE eScript, if you order and pay for delivery here.
Future appointments PrEP requires a pathology test every three months prescribed. We can book this for you, if you have Medicare this is bulk-billed.
Would you like us to book your future appointments ahead, including?(Required) We can book your consults ahead and notify you. You will also get a reminder closer to the date. We will base your appointments around the time you choose this appointment.
Preferred day and time for appointments(Required) Add: +30 Minutes for South Australia, +1HR Queensland, +1.5 HR Northern Territory and +4 Hours Perth.
Confirmation You will be able to book your annual telephone appointment after this submission.
You do not have an Australian Healthcare concession card or Medicare Card. After you complete the form, please follow the links for getting an IHI number to facilitate an eScript. https://prep.health/no-medicare
You confirm that you have a provided a valid Medicare Card.
Coupon Code If you have a referral coupon, please enter it here.
I authorise Prep Health to debit the total charge today amount.
Agreement(Required) Communication Preferences Please Note: You will receive your receipt and referral in two emails after submitting this form. Please check your junk mail as we are talking about sexual health after all!
