<> Prescription Service - Haywood Pharmacy
Haywood Pharmacy

Request Repeat Prescriptions

REPEAT PRESCRIPTION ORDERING SCHEDULE

DAY & TIME YOU PLACE THE ORDER DAY & TIME WHEN MEDICATION IS READY TO BE PICKED UP**
IF ORDERED BEFORE
12:30 PM ON MONDAY		 CAN BE READY FOR PICK UP ON
WEDNESDAY AFTER 4:OOPM**
IF ORDERED AFTER
12:30PM ON MONDAY AND
BEFORE 12:PM ON TUESDAY		 CAN BE READY FOR PICKUP ON
FRIDAY AFTER 4:OOPM**
IF ORDERED AFTER
12:30PM ON TUESDAY AND
BEFORE 12:30PM ON
WEDNESDAY		 CAN BE READY FOR PICKUP ON
MONDAY AFTER 4:OOPM**
IF ORDERED AFTER
12:30PM ON WEDNESDAY
AND BEFORE 11:30AM ON
THURSDAY		 CAN BE READY FOR PICKUP ON
MONDAY AFTER 4:OOPM**
IF ORDERED AFTER 11:30
AM ON THURSDAY AND
BEFORE 12:30 PM ON
FRIDAY		 CAN BE READY FOR PICKUP ON
TUESDAY AFTER 4:OOPM**
IF ORDERED AFTER 12:30
PM ON FRIDAY, SATURDAY
AND BEFORE 12:30 PM ON
MONDAY		 CAN BE READY FOR PICKUP ON
WEDNESDAY AFTER 4:OOPM**

PICKUP OF MEDICATION DEPENDS ON THE AVAILABILITY OF SIGNED PRESCRIPTIONS FROM THE SURGERY.

Collection within the Gt Haywood Area.
Delivery within the Great Haywood Area on request.

We have an arrangement with the following surgeries to dispense repeat prescriptions to patients -

Hazeldene House Surgery, Great Haywood, Stafford, ST18 0SU

Brereton Surgery, St Michaels Community Centre, 88 Main Rd, Brereton, Rugeley WS15 1DU

Rugeley Health Centre, Horse Fair, Rugeley, Staffs WS15 2EL

83 Fernwood Drive, Rugeley, Staffs WS15 2PY

The Surgery, School House Lane, Abbots Bromley, Rugeley, Staffs WS15 3BT

First Names:
Last Name:
Date of Birth: (dd/mm/yyyy)
Address:
Phone Number:
Email Address:
Surgery:
Please tell us what medication you require. Be specific and check your spelling. Please take all details from your repeat prescription record slip.
Drug Name Strength

If you require more than 20 items, please submit another request.
Comments (any comments that you may have about this service)

CONFIDENTIALITY - TERMS AND CONDITIONS
The internet is not secure, and the transmission of data to request medication is entirely at the patient's own risk. The Pharmacy accepts no responsibility for breaches in confidentiality resulting from patients' transmissions.

I accept the terms and conditions above and understand that by ticking this box I give my consent for Haywood Pharmacy to order, pick up and dispense this repeat prescription.
 
Produced by Oldroyd Publishing Group