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Prescription Request Form

Let Croasdales take all the hassle out of collecting your regular prescription items by using our prescription collection service.

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How It Works

 

1. Order your prescription from your GP surgery in your normal way than simply complete the form below to notify us of your request. 

 

2. Once your GP has actioned your request and electronically signed your prescription we will download this from the NHS spine and begin to prepare your items. 

 

3. Please allow us 24-36 hours from receiving your prescription to prepare your items ready for you to collect, if you would rather have this delivered, please specify on the form below. 

 

Delivery Charge

 

We offer two payment options;

 

1. £4.00 per delivery, cash or card payment accepted by our delivery driver.

 

2. £36.00 annual charge, £18.00 for additional members of the same household. 

Choose Your Pharmacy
Birthday
Day
Month
Year
Prescription Charge or Exemption
Collection Method

Croasdales is a trading name of DB & A Cooper Limited & Mountpharm Limited (VAT Registration: GB 344469145 & GB 571335253)

Registered in UK & Wales: 03002084 & 02675076 - Registered Office: C/O Hodson Lewis, Hollow Road, Bury St Edmunds, IP32 7FA

© 2020 All Rights Reserved

Superintendent Pharmacist - Nicholas Cooper. GPhC Number 2030960 
Pharmacy Registration 1037138 & 1110031

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