Prescription Collection - Community Support
Form to collect details of prescription collections, for those in need
Who are you completing this form on behalf of
If you are completing this form on behalf of Another, you must be a Council officer or working for a recognised support organisation.
Please enter your First name as held by the Pharmacy.
Please enter your Surname as held by the Pharmacy.
Please enter the First Line of address, including House name/Number and Street/Road
Please enter the Postcode for your address, where you live. We cover ALL OX11 and some OX12, OX13 and OX14 postcodes near Didcot.
Your telephone, either mobile or landline - no country codes please
Please select which Pharmacy does your medication need collecting from
Which Pharmacy has your Medication, select one listed or input Other... if not listed
Day Lewis Pharmacy - GWP (OX11 6GD)
Woodlands Medical Centre - Lloyds Pharmacy (OX11 0BB)
Didcot Health Centre - Lloyds Pharmacy (OX11 7JH)
Sainsbury's Didcot - Lloyds Pharmacy (OX11 7ND)
Boots - Orchard Centre (OX11 8RG)
NHS Prescription Charges
If you are not exempt or haven't paid your Pharmacy over the phone, you will need to electronically arrange payment to the person assisting you in advance, via something like PayPal friends and family. They will contact you if you select "Other" to arrange payment of NHS charges.
I'm Exempt from NHS prescription charges
I've pre-paid my charges over the telephone
When does this need collecting?
If not immediately available and As Soon As Possible, please give a date for collection.
How many packages of medication need collecting?
Send me a copy of my responses.
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This form was created inside of Great Western Park Residents' Association.