Risk Assessment Form

Certain products and practitioner-restricted items may only be supplied following an appropriate professional assessment in accordance with applicable regulations.

Kennedy’s Pharmacy practitioners are required to exercise professional duty of care and assess the suitability and appropriateness of these products on an individual basis where applicable.

If you are unable to complete this form or have any concerns, please contact us and we will assist you with an appropriate alternative.

Thank you for your cooperation.

Please name the product you are interested in purchasing.
*For children under 12 years of age
Date of the most recent blood test
*This to be used as a guide ONLY, Refer to APF26 the Pharmacy Board Guidelines on Compounding of medicines for more information