Medication Query Form

 
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All questions marked with a * are mandatory

Do you need to order a prescription?: *

This form is not for ordering prescriptions

 How to get a prescription

You are unable to continue using this contact form: *
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Personal Details
Please double check you've entered the correct email address
May be used to identify you
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Your Query

This form is not for clinical purposes

 How to get clinical help and advice

 How to get a prescription

 What to do when we are closed

If you feel that your condition is life threatening please call 999

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