Tel: 0117 955 8154
info@pharmacynow.co.uk

Shaunaks Pharmacy

Free prescription collection & delivery service from all surgeries in Bristol, Corsham, Stonehouse and surrounding areas

Register

Please fill in the short form below to register for our repeat prescriptions service.

After completing and submitting this form, you should receive an email from us within a couple of minutes. If it does not appear, check your junk mail folder as it may have been stored there by mistake.

Fields marked with * are required.

Title:		*
First name:		*
Surname:		*
Email:		*
Address line 1:		*
Address line 2:
City / Town:		*
Postcode:		*
Phone:		*
Date of Birth: e.g. DD-MM-YYYY		*
Your Doctors' name:		*
Your Surgery:		*
Your local Pharmacy:		*
Prescription Cycle:		*
Options:
Please send me reminders for repeat prescriptions
Do you pay for your prescriptions?: Please tick only one box
I'm exempt from repeat prescription charges
I pay for my prescriptions
We recommend you use a password which consists of both upper and lowercase letters, as well as numbers.
Password:		*
Re-enter password:		*
Other:

Shaunaks Pharmacy

Register

Links to our stores