How to order - Ballerine IUB

Patients with a Script

If you are a patient and you have a script from your practitioner, please choose an option below and submit your script to complete your order.
For your convenience, our online Pharmacy will deliver your IUB Ballerine to your practitioner's rooms.

Practitioners & Pharmacies

If you are a South African Registered Healthcare Proffessional
who would like to order the IUB Ballerine for a patient, please click on the link below to be redirected to our ordering platform.

Please complete this form if you wish to claim from your medical aid at any point. Indicate below if you want to claim now or pay the full amount now and claim later yourself. Claiming will not delay your order. As soon as we receive your proof of payment, your device can be delivered.

Patient Name and Surname

Patient ID Number

Contact Number

Medical Aid Name

Medical Aid Plan and Option

Medical Aid Number

Patient Dependant Code

Practitioner Name

Contact Number

Practice Number

Email Address

Physical Address

Province

Postal Code

Upload Script

Items Prescribed

I understand that only the IUB Ballerine is available via this service and that I will get any other items I require from my local pharmacy

I need my device to be delivered by the following date

Delivery Options

I would like the device to be delivered to my Practitioner's rooms I would like the device to be delivered to me

Delivery Address

I prefer to be contacted by the pharmacy or the product specialist via

email whatsapp phone calls

Notes

Please claim from my medical aid now Please invoice me for the full amount so that I can claim it back from my medical aid myself

Patients with a Script

Practitioners & Pharmacies

Quicklinks

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