Repeat Prescriptions

Repeat Prescription Form  -  Private Prescription Quote Form

We can order your repeat prescriptions from your doctor for you; and have it dispensed ready for you to collect or simply wait for it to be delivered.

To join this fantastic service simply phone the pharmacy on 0151 722 1944 to arrange to sign the consent form and leave your repeat order form at the pharmacy.

If you have already signed up just leave your details below and order your medicines. We need five working days before you can collect your medicines or have them delivered. For more urgent requests please phone the pharmacy.

IF YOU HAVE ALREADY ORDERED YOUR PRESCRIPTION DIRECTLY FROM THE SURGERY AND WOULD LIKE US TO PICK IT UP, PLEASE INFORM US. YOU CAN DO THIS VIA THE 'CONTACT US' PAGE, REMEMBERING TO INCLUDE YOUR OWN AND YOUR SURGERY'S DETAILS.

Repeat Prescription Request Form

First Names:
Last Name:
Date of Birth:	(dd/mm/yyyy)
Address:
Phone Number:	Home Work Mobile
Email Address:
Surgery:	Please Select Your Surgery Oakvale Medical Centre Rocky Lane Medical Centre Dr. Orlans Valley Medical Centre Lance Lane Medical Centre Rutherford Road Penny Lane Medical Centre Old Swan Health Centre Rock Court - Old Swan Derby Lane Medical Centre Belle Vale Health Centre Edge Hill Health Centre Childwall Park Avenue
Surgery not in list? Then then please enter it here:

Please tell us what medication you require. Be specific and check your spelling. Please take all details from your repeat prescription record slip.

Drug Name	Strength

If you require more than 8 items, please submit another request.

Comments (any comments that you may have about this service)

CONFIDENTIALITY - TERMS AND CONDITIONS The internet is not secure, and the transmission of data to request medication is entirely at the patient's own risk. The Pharmacy accepts no responsibility for breaches in confidentiality resulting from patients' transmissions.

	I accept the terms and conditions above and understand that by ticking this box I give my consent for Udani Chemist to order, pick up and dispense this repeat prescription.

Private Prescription Quotes Form

We charge competitive prices for dispensing private prescriptions.
Contact us for a quote - 0151 722 1944 or complete the form below -

Name:
Telephone No:
Email Address:
Details of prescription required:

Udani Chemist
22-24 Queens Drive
Liverpool
L15 7NE

Tel: 0151 722 1944
Fax: 0151 475 1734
Email: lipotrim@gmail.com

Directions

Enter your postcode in the box below for directions

How do I check that this is a genuine pharmacy. We are regulated by the General Pharmaceutical Council.
www.pharmacyregulation.org

We are registered with the Royal Pharmaceutical Society of Great Britain.