Username or Email Address
Password
Remember Me
Or directly upload your prescription below.
Your name
Your Identification number
Your Phone Number
Your email
Patient Type: —Please choose an option—KPJ Staff or KPJ Staff's Family MemberKPJ Pahang Staff or PatientKPJ Tawakkal Staff or PatientmyPESARA CommunityPublic
Your Prescription extension allowed jpeg, jpg, png, and pdf
Delivery Option PostageSelf Pickup at Healthshoppe + Pharmacy Menara KPJ,KLSelf Pickup at Healthshoppe + Pharmacy DSH2,KL
Self Pickup Location Healthshoppe + Pharmacy (Menara KPJ) Lot G-1B, Ground Floor (Podium) Menara KPJ, No 238 Jalan Tun Razak 50400 Kuala Lumpur
Your Address
Address:
Address 2:
City:
Postcode:
State:
Country:
I need medication supply for:1 month supply2-month supply3-month supply4-month supply5-month supply6-month supply1 year supplyOthers
Additional remarks:
I declare that this upload is the original Prescription Copy. I understand that any unauthorised changes or amendments done to the original version, may lead to the order being not processed. I also understand & I am agreeable that the original prescription be collected prior to medication delivery.
Username or email address *
Password *
Log in
Lost your password? Remember me
No account yet?