Prescriptions

PRESCRIPTION PROCESSING

PLEASE ALLOW SEVEN WORKING DAYS FROM INITIALLY ORDERING YOUR PRESCRIPTION TO COLLECTING YOUR MEDICATION AT THE PHARMACY

Please complete the following form to order your medication online.

"*" indicates required fields

Title*

Forename*

Middle Name Optional

Surname*

Date of Birth*

Address*

Street Address Address Line 2 State / Province / Region Post Code Country

Phone*

Email*

Enter each medication and strength on your prescription*

Medication

Strength

Dose

Please click the ”

” icon above if you would like to add more medications to the list

Pick Up Point*

PLEASE NOTE WE DO NOT HAVE A REGULAR COLLECTION FROM DUNDONALD PHARMACY OR MONKTON PHARMACY SO YOU WOULD NEED TO INFORM THEM TO COLLECT AT LEAST 3 WORKING DAYS AFTER ORDERING.

Please select which Surgery you are registered with*

Remember me?

Yes Optional

Remember my details – We’ll save a copy of your details on your computer and pre-fill them automatically when you next visit this page. Do not select this option if you are using a shared device