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Doctors Stevens, Harrison, Cassidy, Parsons & Stimson     01280 702436
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Online Prescriptions 

PLEASE NOTE that this form is only for patients registered with Washington House Surgery
77 Halse Road, Brackley, Northamptonshire

   
  First Name *   * You must provide this information.  
  Surname *    
  Date of Birth *    
  Contact Telephone *  

 

  
  Address *    
           
               
  Item   Strength        
  e.g. Paracetamol   e.g. 500mg        
   

     
         
         
         
         
         
         
         
         
         
               
  Comments      

                                 

 

Online Prescription Security
PLEASE NOTE this is NOT a secure form.
This form is sent to us 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.

 

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