Patient declaration on pharmacy choice Patient and The Body Clinic

I am aware that I have the right to freely choose the pharmacy where I redeem my prescriptions in accordance with Section 31 (1) sentence 5 SGB V. I have decided to redeem my prescription digitally via The Body Clinic platform. I am aware that I can only redeem my prescription in this way at pharmacies that cooperate with The Body Clinic. I am free to choose between the pharmacies that cooperate with The Body Clinic.

I would like my prescription to be filled at the following pharmacy and delivered to me by mail order or courier:

• Witzleben Apotheken oHG, Witzleben Apotheke 26, Kaiserdamm 26, 14057 Berlin