carter chemist

  over 60 years of service

 

Repeat Prescription Request

Service currently available for patients of:

Eastbury Surgery - Dr. Goodwin & Partners

Northwood Health Centre - Steven Shackman Practice

                                     Acre Way Surgery

                                     Care Point

                                     Dr. Haring

First name

Surname

Your address

The name of your doctor

Surgery address

The items you request

Note: This form is being submitted using e-mail. You should have created a profile with an email editor such as Outlook Express in order to be able to submit the form. Please press the submit button only once. Since the form is submitted via email you will not receive an acknowledge receipt of your form. Please wait for the pharmacy to send you a confirmation.

Alternatively, send your prescription request to

 carterchemist @ btconnect.com

Your request should contain your name and address, your doctor name and address and the items you request.

© Carter Pharmacy 2006. All rights reserved.