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The Chemist Shop – Repeat prescription service
IF YOU ARE UNABLE TO LEAVE YOUR HOUSE WE CAN COLLECT & DELIVER YOUR PRESCRIPTION FREE OF CHARGE
If you take regular prescribed medication, you will know how time consuming it can be to go to the doctors’ surgery, then to collect your prescription and go to your chemist to have your medication dispensed. The Chemist Shop can help. We will order and collect your prescription from the surgery. This will then be dispensed ready for you to collect or to have delivered to you. It saves time, no waiting for stock to be ordered. One call to order that’s all you need to do. JUST FILL IN THE DETAILS AND WE WILL DO THE REST REPEAT PRESCRIPTION SERVICE
PATIENTS DETAILS Title (Mr/Mrs/Miss/Dr):................................................................................................................................. First Name: .................................................................................................................................................... Surname:........................................................................................................................................................ Address: ......................................................................................................................................................... .......................................................................................................Postcode: ................................................ Tel: ......................................................................................... Date of Birth: ................................................ Doctors Name: .............................................................................................................................................. Surgery Address:........................................................................................................................................... .......................................................................................................Postcode: ................................................ Surgery Tel:....................................................................................................................................................
I hereby authorise The Chemist Shop, Peterborough to collect, either in person or by means of electronic transfer, prescriptions from the surgery shown above on my behalf. I will inform you if I wish to make any changes to this agreement.
