Repeat Prescriptions

FREE PRESCRIPTION COLLECTION
& DELIVERY SERVICE (for the housebound or elderly)

Do you request repeat prescriptions from your local surgery? Arranging for it to be picked up, getting it to a local pharmacy and then waiting for it to be dispensed can be time-consuming!

At The Village Pharmacy we can make it easier. Did you know that you can request your repeat prescription from your surgery as normal and then ask for it to be sent to or collected by The Village Pharmacy? We can then have it ready and waiting in our pharmacy when you call for it or when we deliver.

We will seek not only to provide remedies for those who are already ill, but also to promote healthcare by the provision of information and advice.

We have an arrangement with the following surgeries to dispense repeat prescriptions to patients -

DR HORDEN & PARTNERS of The Village Community Medical Centre

This service is only available to patients of these surgeries who have a valid, up-to-date, repeat prescription.

First Names:
Last Name:
Date of Birth:	(dd/mm/yyyy)
Address:
Phone Number:	Home Work Mobile
Email Address:
Surgery: Please confirm with us that your surgery is covered by our catchment area.

Please tell us what medication you require. Be specific and check your spelling. Please take all details from your repeat prescription record slip.

Drug Name	Strength

If you require more than 8 items, please submit another request.

Comments (any comments that you may have about this service)

CONFIDENTIALITY - TERMS AND CONDITIONS The internet is not secure, and the transmission of data to request medication is entirely at the patient's own risk. The Pharmacy accepts no responsibility for breaches in confidentiality resulting from patients' transmissions.

	I accept the terms and conditions above and understand that by ticking this box I give my consent for Village Street Pharmacy to order, pick up and dispense this repeat prescription.