All reasonable steps have been taken to ensure that the script is available for collection, and if legally permitted during the COVID19 pandemic, the script will be emailed directly to the pharmacist. Should the script be lost, misplaced, not collected, alterations to the dosing at your or the teacher's request/advice, change of pharmacy or expire an additional script fee will apply. To prevent any misunderstanding, please note: We do not send accounts to Medical Aid unless specifically requested with Dr. Flett. Fees are charged at Discovery Executive Package Medical Aid rates. If you are not on this plan, your medical aid may not cover the full fee. They pay a benefit based on the cover you have chosen. Please note weekend and after hour services are charged at higher rates and rates are dependent on complexity and hours of service. Patients must pay at consultation. Due to increasing bad debt, administration and legal costs, the following conditions apply (office hours): • Invoices are due on presentation • We do not phone medical aids • You are responsible for settlement of fees charged regardless of whether we do/do not submit the invoice to Medical aid. • If Medical Aid pays you, please pay us within 7 days of receipt of payment. • It is advised that you monitor all invoices with your medical aid. We do not ‘write off’ unpaid fees. All accounts in default (as detailed above) are referred to our Attorney for recovery. You will be liable for all costs on an attorney-own client basis. Missed appointments not cancelled within 24 hours will be charged for. These terms and conditions automatically apply to all your dependents whether listed or not. Your de-identified information may be used for epidemiological, research, or practice business planning and may be passed on in a de-identified format to third parties for further processing. For the accuracy of health care planning, it is important that as much information as possible included in these types of analyses and that your participation in this regard is highly appreciated. I understand the implications and agree, where appropriate, to the doctor and practice disclosing my ICD-10 diagnostic code under the conditions described above. I accept these conditions. I confirm that I am not under an administration or insolvency order. I nominate my residential address as recorded alongside to be my domicilium citandi et executandi. I consent to the jurisdiction of the Magistrate Court in Durban notwithstanding the amount of the claim against me.

After submission of this form you will be directed to a payment Gateway. Please note no script will be processed until payment has been received.