Submit Prescription 1Start 2Recipient 3Location 4Payment Prescription Submission Welcome. Submit your prescription document for our review. Get Started Patient Information Myself Dependant BackNext Step Delivery Address & Notes BackNext Step Preferred Payment Method Note: Payment will only be processed after we confirm your prescription. Self Pay Smart MTIBA Slade360 LCT Preferred Self-Pay Method * Cash on Delivery Mpesa Insurance Provider Name Upload Claim Form Image/PDF * You can take a photo using your camera or browse files from your computer Upload Insurance Card (Front Face) Image/PDF * You can take a photo using your camera or browse files from your computer Upload Prescription Image/PDF * Back Finalize Submission