Repeat Prescriptions

We have arrangement with all local surgeries to dispense repeat prescriptions to patients -

This service is only available to patients of these surgeries who have a valid, up - to - date, repeat prescription.

Please Note: We are also able to accept prescriptions electronically using the secure NHS Electronic Transmission of Prescriptions Programme (ETP); ask us for details.

First Names:
Last Name:
Date of Birth: (dd/mm/yyyy)
Address:
Phone Number:
Email Address:
Surgery:
Please tell us the drugs you require. Be specific and check your spelling. Please take all details from your repeat prescription record slip.
Drug Name Strength

If you require more than 8 items, please submit another request.
Comments (any comments that you may have about this service)

CONFIDENTIALITY - TERMS AND CONDITIONS
The internet is not secure, and the transmission of data to request medication is entirely at the patient's own risk. The Pharmacy accepts no responsibility for breaches in confidentiality resulting from patients' transmissions.

I accept the terms and conditions above
 

Private Prescription Quotes

We charge competitive prices for dispensing private prescriptions.

Contact us for a quote - 020 8654 1065 or complete the form below -

Name:

Telephone No:

Email Address:

Details of
prescription required:


 

Approved Private Prescriptions

You need to complete this form only if your prescription request has been approved

Name
(forename and surname)*:

Address 1*:

Address 2:

Town*:

County:

Country:

Postcode*:

Contact number*:

Email:

Authorisation Code*:

Prescription Item*:

Total fee quoted for
prescription (QPF):
Deliver to my address
above:

Pharmacy Name:

Postcode (to collect
medications)*:


Security - please enter the
number in the image above
into the box*:
 
All fields marked with * are mandatory

 
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