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Number 18 Surgery
18 Upper Oldfield Park
Bath
BA2 3JZ

Appointments
01225 427403

All other enquiries
01225 427402
 
 

 
 
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Please Note: This form is sent to us via computers that do not belong to the NHS in a non-encrypted format. Complete confidentiality for this type of repeat prescription request can not be guaranteed.

If you have an issue with this please feel free to use our normal repeat prescription service or you can sign up for our secure online service.

 
Patients Name *  
Date of Birth *    
Address *    
Contact Tel.    
Your Chemist  
Your Doctor    
     
* You must provide this information    
 

     Item Description

  Quantity
       (e.g. Paracetamol) (e.g. 100)
     
Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
Item 7
Item 8
       
Additional Comments

 

                          


Please allow 2 full working days for us to process your request.

(We can only post your prescription to you if you provide us with a
Stamped addressed envelope)


 
 
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