If you suffer from Coeliac's Disease then you might qualify or be entitled to a Ministry of Health subsidy towards your gluten free food. To apply, please carefully read the terms and conditions below. Download and complete the relevant forms and get them signed off by your doctor or dietitian and return them to us.

Processing a prescription with the Hospital to Home (H2H) programme

Coeliac prescription forms

• PRINT then complete all areas of the form that are applicable

Canterbury DHB
South Canterbury DHB
Southern DHB
West Coast DHB
Nelson DHB
Hutt Valley DHB

Terms & Conditions

Patient information
​Ensure all information requested in the “Patient to complete” section, including the quantity of goods required in the ‘pkts’ column (packets) is completed.

Doctor or Dietitian information
Ensure all information requested in the “Doctor or Dietitian to complete” section has been completed and signed by your Doctor or Dietitian

Where to send
completed form can be:

• faxed to 0800 11 83 22
• emailed to prescriptions@crombie-price.co.nz
• posted: P.O. Box 121 Oamaru

We do not require the original to be posted.

Payment Details
Upon receipt of the SIGNED prescription form we will post, email or fax a pro forma invoice directly to the patient.  The Pro-forma invoice details the total price to be paid by the patient for the prescription. If the patient’s cell phone number has been provided to us, we will text the amount payable to them.  

• Payments can be made with cheque, bank transfer or Credit Card (Visa or Mastercard only)
• Upon confirmation and payment of the pro forma invoice by the patient we will dispatch the prescription by courier.  
• Delivery by courier for the ‘Hospital to Home’ Program is free to the patient’s residence or a nominated address.                                                                                                                                           

Notes ​

Products are subsidised by the Ministry of Health, however there is a part charge on all the Gluten Free Foods schedule, this is the amount invoiced.   

• All patients have an approval number making them exempt from the usual limitation of waiting 3 months to reorder, as long as each prescription is signed by a doctor.
• Co-Value Charges: We only require the expiry date information for patients that hold the following health cards i.e. CMS/HUHC/PSC/Gold.  Do not enter the entire card number, just the expiry information. Having the expiry date details will ensure that you are charged the correct Co-Value (government charge). 
• Patients are eligible for a Prescription Subsidy Card if their total number of prescriptions during the year exceeds 20.  Patients should keep their Crombie and Price invoice and provide them to their usual prescription issuing pharmacy. This will assist in adding to their overall total of prescriptions per year.  

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