Register for Online Services - Prescription Service

To order your prescription online you are required to register for our online services you will need to complete this form. You will then be contacted by one of the team to confirm your details. We will then email you a link to set up your account.

Please note the email link may appear in your junk mail folder.

Last Updated: 17/10/2024

Register for Online Services

Name *

Date of Birth *

Phone Number *

I consent to practice contacting me by text messaging *

Yes No

Email Address (not a shared email address) *

Address *

Postcode *

Which online services would you like access to? (tick all that apply) *

Order Prescriptions

Make an Appointment (not currently available)

Cancel an Appointment (not currently available)

View Medical Summary (not currently available)

I understand that It is my responsibility to keep my account secure by keeping my details confidential. I understand my details will be kept on my electronic record. If I choose to share my information with anyone else this is at my own risk. I will contact the practice if I suspect that my account has been accessed by someone without my agreement. *

I consent to the practice collecting and storing my data from this form.

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Register for Online Services - Prescription Service

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