Online Customer Request

Ballinasloe – Duane Pharmacy

Please fill out the below form in order to request a prescription to collect in store. Please note this is not an ordering service, and does not take payment, but a request.

Please fill out the below form.

    Upload an image of your prescription request. (optional - only if we don’t have it on file.)


    Any shop essentials or over the counter remedies required? If so, please list..

    Please select your payment method:

    Pay in-storePay over the phone

    Date for collection

    We will contact you when your request has been completed - thank you for your patience.

    Call

    090 964 2148

    Monday - Saturday

    9.30 AM - 6.00 PM

    Text

    087 376 3252

    Location

    Society St, Ballinasloe, Galway, H53 P7D3

    Email

    duanes@healthwisepharmacies.ie

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