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St Paul’s Medical Centre
Dickson Road
North Shore
Blackpool
FY1 2HH

Tel: 01253 623896
Fax: 01253 752818
Location
 

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This form is for St Pauls Medical Centre patients only.
Click here for Ashfield Road prescriptions

Please note this is not a secure form.

This form is sent to our dedicated email address via computers that do not belong to the NHS in a non-encrypted format. Complete confidentiality for this type of repeat prescription request can not be guaranteed. If you have an issue with this please feel free to use our normal repeat prescription service.

If you are collecting your repeat prescription, please attend the surgery after 3pm, two working days after your online request.

 
Patients Name *  
Date of Birth *    
Address    
Contact Tel.*    
Your Doctor    
Please select where you want to collect your prescription  
* You must provide this information.    
 

     Item Description

 Quantity
       (e.g. Paracetamol) (e.g. 100)
     
Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
Item 7
Item 8
Item 9
Item 10
Item 11
Item 12
   
* Not for medical problems *
   
Comments about this Prescription
 

 


 
   

 

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