Prescription Registration Form

Complete the three stage form below to register for Electronic Prescriptions, we will then communicate with your GP to complete the registration process.

1. Patient Details

By signing up for text alerts, we are able to send you information to let you know your delivery is on its way. Text alerts will be sent on the day of delivery due out that afternoon. Please allow 3-5 working days from ordering to receiving delivery.

Address

Alternative Delivery Address

2. Your GP Details (Click Here)

Surgery Address

What is a Summary Care Record (SCR)?

The NHS SCR is an electronic summary of key clinical information (including medicines, allergies and adverse reactions) about a patient, sourced from the GP record. It is only used by authorised healthcare professionals, with the patients’ consent, to support their care and treatment.

3. Exemption Details (Click Here)

If you are not exempt, you must contact us on 01924 900113 to provide card details. We have a secure method of payment, and a receipt will be attached to the medication indicating the amount paid. payment types

This form is GDPR compliant. To provide this service we will need to collect some personal data about you, which may include sensitive information about your health. By registering to use our pharmacy services you agree that we may use this information to give you the best care and advice we can. Please see our Privacy Policy to see how we protect and manage your submitted data. We will never sell your information to third parties.

Quick Contact

If you would like us to contact you regarding our prescription services, complete our quick contact form by clicking the button below.

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