Claim an itemised health fund receipt Please ensure that you have read and understood our Returns and Receipts policy. To claim your itemised health fund receipt, please fill in the below details and we will issue this as soon as possible! Name * First Name Last Name Order Number * Child's Full Name * First Name Last Name Child's Date of Birth * MM DD YYYY Email * Upload Prescription * FileField;MaxSize=5120;Multiple;addText=Upload_your_Child's_Prescription_Here; Thank you!