This online form will save you time on your visit to Hickey’s Pharmacy. If you request the pharmacist to call you, most of the consultation can occur by phone before you visit the store. Otherwise the pharmacist will have your form ready and they will have a private consultation with you in the store. This takes a few minutes to complete.

This service is open to women over the age of 17 years old. If you are under 17 please call the pharmacy to discuss your options.

This helps us to choose the correct product. One of the products can be taken up to 5 days (120 hours) after unprotected sex, but with all emergency contraceptives the sooner emergency contraception is taken the more effective it is.

Additional Information

This helps the pharmacist establish the risk of pregnancy. Leave blank if unknown.

Customers must attend in person to collect the morning after pill.

Emergency contraception can be taken more than once in a cycle, but the pharmacist needs to know this, so they can select the most appropriate product.

Other Medication

Some customers are on medication that could make the morning after pill less effective. The following questions help the pharmacist establish the best emergency contraception option for you:

Select a store

What happens next?

Once you click submit, your chosen pharmacy will receive your details. The pharmacist will review the information and prepare for your consultation. If you request a phone consultation by entering your phone number below the pharmacist will call you to carry out the consultation over the phone. Your medication will be ready for collection within 1 hour (during store opening hours). You will still need to come to the pharmacy yourself to collect the medication.

Contact Phone Number