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Please only use this form for emergency requests. This request is for 14 days of medicine.
Copy exactly the details from a prescription slip you have received from the practice.
Please note that items will only be dispensed if they are included in a prescription from the practice and a medication review is not pending.
THIS IS FOR URGENT PRESCRIPTIONS – PLEASE NOTE THAT THIS IS ONLY FOR A 14 DAY SUPPLY.
PLEASE DO NOT USE THIS FORM FREQUENTLY – IT IS FOR EMERGENCIES ONLY. THE TEAM WILL MONITOR ITS USE AND THE SERVICE COULD BE WITHDRAWN IF IT IS BEING OVERUSED.