REQUEST FOR REPEAT PRESCRIPTION

Please identify and describe yourself:

First Name:
Last Name:
Address:
Town:
Postcode
Telephone
Medication Required
Where will you collect this prescription:
Declaration: I understand that this information is being sent to the practice via standard e-mail and that LVMG accept no responsibility for its loss or interception before receipt in the practice.

Your prescription will be ready for collection after 48 hours.

Pharmacist - Did you know that Pharmacists are qualified to give advice on common complaints, such as colds, flu, sore throats, aches and pains.

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