Home About us Prescriptions Health Promotion Feedback Complaints Contact us Health Conditions You are here: Home Consent Form (Repeat Delivery) Primary Sidebar SUPPORT What is this? CATEGORIES News and Offers Uncategorized Consent Form (Repeat Delivery) Patient Details Name Date of Birth Address Phone Please give the name of the pharmacy (chemist) where you normally have your prescriptions dispensed (if applicable). Pharmacy Name I am the above named patient or patients’ carer. By clicking to submit this form, I agree that iPharm will make arrangements for all my future prescriptions to be dispensed in this way including Electronic Repeat Dispensing. If I wish to change this arrangement I will inform iPharm UK. I wish to nominate iPharm UK Ltd to: Order my prescription from the surgery. Collect my prescription from the surgery. Deliver my medication to me. Name of medication(s) (if known): Medication/s are due on (if known): Doctors Details GP Name GP Address GP Phone Number Secondary Sidebar INFORMATION RECENT POSTS CPPQ Results 2019-2020 COVID-19 Update Should you move to the repeat dispensing service? Coronavirus Advice Dry January Calendar Copyright © 2021 iPharmUK | The Online Pharmacy. Powered by WordPress and Envince.

Home About us Prescriptions Health Promotion Feedback Complaints Contact us Health Conditions You are here: Home UncategorizedCPPQ Results 2019-2020 Primary Sidebar SUPPORT What is this? CATEGORIES News and Offers Uncategorized CPPQ Results 2019-2020 CPPQ Ipharm 201920 Posted in Uncategorized LEAVE A REPLY Your email address will not be published. Required fields are marked * Comment Name * Email * Website Previous Post: COVID-19 Update Secondary Sidebar INFORMATION RECENT POSTS CPPQ Results 2019-2020 COVID-19 Update Should you move to the repeat dispensing service? Coronavirus Advice Dry January Calendar Copyright © 2021 iPharmUK | The Online Pharmacy. Powered by WordPress and Envince.

Home About us Prescriptions Health Promotion Feedback Complaints Contact us Health Conditions You are here: Home UncategorizedShould you move to the repeat dispensing service? Primary Sidebar SUPPORT What is this? CATEGORIES News and Offers Uncategorized Should you move to the repeat dispensing service? eRepeat-Dispensing-leaflet Posted in Uncategorized LEAVE A REPLY Your email address will not be published. Required fields are marked * Comment Name * Email * Website Previous Post: Coronavirus Advice Next Post: COVID-19 Update Secondary Sidebar INFORMATION RECENT POSTS CPPQ Results 2019-2020 COVID-19 Update Should you move to the repeat dispensing service? Coronavirus Advice Dry January Calendar Copyright © 2021 iPharmUK | The Online Pharmacy. Powered by WordPress and Envince.