Welcome to H B Dunn Dispensing Chemist : You can find us at 87 Regent Street Leamington Spa, CV32 4NT, Tel: 01926 424796 : Prescription Service

This service is only available to patients of these surgeries who have a valid, up-to-date, repeat prescription.

First Names:	*
Last Name:	*
Date of Birth:	(dd/mm/yyyy) *
Address:
Phone Number:	*
Email Address:	*
Surgery:

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

Medication Name	Strength	Quantity

Please leave 3-4 working days on average following your request to allow us to order your medication and for the surgery to return your completed prescription

If you require more than 12 items, please submit another request.

Comments (I am registered disabled therefore please deliver the medication to my home)

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.

Delivery service is at the discretion of the store manager. We cannot be held responsible for any delays from the surgery while issuing prescriptions.

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

Repeat Prescriptions