Waterfront Medical Centre Nominated Pharmacy
Please use this form to nominate a pharmacy of your choice for your repeat / acute prescriptions.   You will only need to complete the form once unless you change your nominated pharmacy.

This will allow the Practice to automatically send your prescription (allow 72 hours) to your nominated pharmacy removing the need for you to collect your repeat prescription from the surgery reception and instead just collect your medication directly from your nominated pharmacy.

(Please note: This does not apply to any controlled drugs as you will still need to collect and sign for these at the surgery)
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Full Name *
Date of Birth *
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Address *
Nominated Pharmacy Choice *
Signature *
Date Completed *
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Submit
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