Prescription Request

Please be aware that this is not a secure/encrypted service. All information you send to us is at your own risk and we cannot enter into any correspondence via emails. If you have any queries, please telephone the surgery in the usual manner.


Please complete all of the contact details fields.

Contact Details
Date
Forename
Surname
Date of birth (note:please use same format)
Email address
Contact tel.number

Please enter your required medication below:
Drug Name
Dosage
   
Any other information regarding your prescription:
 
 
   
   

Thank you for your prescription request

Please allow 48 working hours before collecting your prescription from the surgery

 

 

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