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Pharmacy Nomination Form

Home Pharmacy Nomination Form
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1. Sign up to the Electronic Prescription Service via our online form

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2. Your GP will create your prescription electronically ready to send off

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3. Our pharmacy team will receive the electronic prescription and dispense your medication for you

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4. You’ll receive your prescription in a more convenient, secure and reliable way

Sign-up to our Electronic Prescription Service

We offer the fastest possible prescription service to our community by virtue of using the Electronic Prescription Service. Electronic Prescriptions can be sent directly to Liverpool Road Pharmacy from any GP surgery. This ensures that once your GP has signed the prescription, we will receive it immediately. Electronic prescriptions are always secure, reliable and confidential – with the added benefit of no back and forth with the usual paper-based prescription.

 

All our patients are offered the choice of opting into this service. If you are happy to use this service, please fill in the form below to be enrolled onto our Electronic Prescription Collection Service.

  • Date Format: MM slash DD slash YYYY
  • (This can be found in the top right-hand section of your prescription)

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