Register NHS

Patient Details

This form is to register for NHS prescription services. It does not request medication. Please continue ordering prescriptions via your GP or NHS App.

Full Name(Required)

Enter your full legal name.

Date of Birth(Required)

Your date of birth is required for pharmacy records.

Gender(Required)

NHS Number

If known, please enter your 10-digit NHS number.

Email Address(Required)

We will use this email address to send confirmations and updates.

Phone Number(Required)

We may contact you if we need to confirm any details.

Address(Required)

Street Address Address Line 2 City Post Code

Prescription Details

Do You Pay For Your Medication?(Required)

Prescription Exemption(Required)

How many days of medication do you have left?(Required)

Delivery Preference(Required)

Delivery preferences will be confirmed by the pharmacy to ensure safe and accurate delivery.

Safe Place Instructions(Required)

Tell us where we should leave your medication if you are not home.

Additional Notes

Please provide any additional information regarding your medication, delivery preferences, or other important details.

GP Details

GP Practice Name

Enter the name of your GP surgery if known.

GP Practice Postcode

Enter the postcode of your GP surgery if known.

Consent to contact my GP if needed(Required)

Yes

I consent to the pharmacy contacting my GP practice if needed to support my prescriptions or pharmacy services.

Warning — Please Read

GP notification recommended

We recommend informing your GP for continuity of care. A clinician may discuss this with you.

Declarations

CAPTCHA

What to expect

Sign up using our NHS Registration form and we will add you to our pharmacy so your repeat prescriptions are sent directly to us for dispensing and delivery.

Processed within 1 working day
Delivered within 2–3 working days
For urgent medication, please call 01785 258 181

Next steps

Complete the NHS registration form

Check your email for confirmation

We review and process your details

Your prescriptions are sent to our pharmacy