Prescription Delivery Request
Please use this form to request the collection and delivery of a prescription.
This service is provided by volunteers from the Trinity Delivery Team (see
) coordinated by Jo Swain and operating within and around Ashby de la Zouch, Leicestershire in the UK.
Deliveries are possible from a limited number of pharmacies to homes within LE65
Ashby Pharmacy, 17A The Green, Ashby-de-la-Zouch LE65 1JU
Boots, 32 Market St, Ashby-de-la-Zouch LE65 1AL
Dean and Smedley, ASCEBI HOUSE, 118 Burton Rd, Ashby-de-la-Zouch LE65 2LP
The first and last name of the person receiving the prescription
Preferred Phone Number
The preferred phone number (mobile or landline) for the recipient (person receiving the prescription).
Address (First Line)
The home address of the person receiving the prescription. Prescriptions can only be delivered to the addresses in LE65 registered with the doctor and pharmacy.
The post code for the address above.
Collection Ready from
Collections will happen on Tuesdays, Wednesdays and Fridays, please ensure that the prescription will be ready in good time for the collection slot.
8:00 am Monday
8:00 am Wednesday
2:00 pm Friday
No Payment Required
Please confirm that there will be 'nothing to pay' on collection. This service is provided free of charge and staffed by volunteers. We are unable to make payments to pharmacies on your behalf.
No Payment required
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This form was created inside of Holy Trinity Ashby.