Prescriptions McLaren Health Prescriptions Full Name* First Last Email Date of Birth* Day Month Year List of medications requested and any instructions:*Pharmacy to send to or pick up at the clinic* - Scripts cost $15 for an adult over age 19 years. - Scripts cost $5 for children aged 14 - 18 years. - Scripts are FREE for children aged 13 years or under. - There is NO extra cost to fax a script to a pharmacy. Please pay by internet banking to 12-3011-0450502-00 and put your full name in the reference boxes. Alternatively, you can come in person and pay at the clinic.CAPTCHAEmailThis field is for validation purposes and should be left unchanged.