Request Prescription
| |
 |
Please fill in all the grey boxes. |
| |
|
Use the
TAB button on your keyboard, or use your mouse to
the next box. Please do NOT hit Enter on your keyboard.
If you do this, you will be told you have not filled in
the form correctly and asked to do it again. |
| |
|
You must
be a registered patient to use this service. If you are
not registered, your request will be ignored. You can
only request a prescription from the surgery whom you
are registered with. |
| |
|
If you
need to change your collection point, please do so on
the 'Change Collection Point' page. This change will
NOT be instant and your prescription will be sent to
your usual collection point for this request. |
|
Important
You must accept the Terms & Conditions of this
service and tick the checkbox at the bottom of this form.
You will not be able to use this form without accepting
our Terms & Conditions of Service.
|
|
|
