Private Prescription Request

Patient Details
Tell us your details first
Full Name*
Address*
Street Address City Postcode
Date of Birth*
Date Format: DD slash MM slash YYYY
Preferred Contact Method*
- Email
- Phone
- Mobile
Email*
Phone*
Mobile*
If you are local to us, which branch would you like to uplift from?*
If you would like the prescription posted we can deliver to anywhere in the UK, via first class recorded mail - just select Blairgowrie, and answer yes below.
Do you require your medication to be posted?*
You have the option of having your medicines delivered, either to your home or to any other address in the UK. Your prescription will be delivered by Royal Mail, parcel recorded service. You must be present in person to take delivery of your medicines and you may be asked for photo ID. Our delivery charge is that of standard post office fees, £3.90 for 2nd class and £4.40 for 1st class, please advise if you wish 1st or 2nd option.
Prescriber Details
Full Name*
Address*
Street Address Address Line 2 City Postcode
Profession*
Medication Details
No of Items*
- 1
- 2
- 3
Item 1
Medication Name*
(including strength and form e.g. paracetamol 500mg tablets)
Directions*
(e.g. two to be taken four times a day)
Quantity*
(e.g. 100)
Item 2
Medication Name*
(including strength and form e.g. paracetamol 500mg tablets)
Directions*
(e.g. two to be taken four times a day)
Quantity*
(e.g. 100)
Item 3
Medication Name*
(including strength and form e.g. paracetamol 500mg tablets)
Directions*
(e.g. two to be taken four times a day)
Quantity*
(e.g. 100)
For private prescriptions to be valid, they must be written by a prescriber registered within the European Union (EU). Prescriptions will be verified before supply.
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Phone
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Private Prescription Request

Patient Details

Prescriber Details

Medication Details

Item 1

Item 2

Item 3