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Parcel Pharmacy Nomination Form

    Thank you for choosing Parcel Pharmacy!  😊

    Complete this form if you would like to make Parcel Pharmacy your nominated pharmacy to receive your NHS electronic prescriptions. We are an NHS online pharmacy providing a convenient FREE prescription delivery service nationwide, as well as online video consultations for a range of conditions. We aim to deliver prescription medicines the same day or next day, wherever possible, directly to your chosen address.

    Important

    • This form is only for requesting an NHS Electronic Prescription Service (EPS) nomination.
    • We will verify your details before updating your NHS EPS nomination.
    • By submitting this form, you confirm that you are requesting this change yourself or you have the legal authority to do so on behalf of the patient.
    • We may contact you if we require further information.
    • The information submitted through this form will be used by Parcel Pharmacy to process your NHS EPS nomination request, verify your identity and contact you about the request (if needed). Please read our Privacy Notice available in the footer of our website https://www.parcelpharmacy.com/
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Full name *
Date of birth *
NHS number (if known)
Gender *
Address *
Post code *
Mobile number *
Signature (Type your full name as your electronic signature) *
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