Travelling with Prescribed Controlled Medicines

Fees Apply

A separate form should be completed for each person who is travelling.

Full Name(Required)
Address(Required)
Street Address Address Line 2 City Post Code Country
Date of Birth(Required)

Day
Month
Year
Age(Required)
Contact Telephone Number(Required)
Date of Departure(Required)

Day
Month
Year
Date of Return(Required)

Day
Month
Year
Country you are visiting

Please list the countries and areas you are due to visit, including any stop overs. You should include shorts stays in airport terminals.
Length of Stay(Required)
Please list your medications you will be taking(Required)
Controlled Drug Medication Dose Quantity you will be taking

Controlled Drug Medication	Dose	Quantity you will be taking