Prescriptions

Full Name (required)

Date of Birth (required)

Postcode (required)

Address (required)

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Country

Contact telephone number (required)

Mobile phone number

Email Address

Your GPs name (required)

Surgery name (required)

Postcode

Surgery Address (required)

City (required)

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Contact telephone number (required)

Surgery email address

Do you pay for your prescription? (required)
—Please choose an option—yesno

Repeat this prescription
no-repeatevery weekevery 2 weekevery monthevery 2 monthevery 3 month

Please note a charge of £8.20 will apply per item. Please contact us about payment options before requesting a collection of a prescription or posting us a prescription

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