Prescription Alignment Request

An alignment of medication means all your regular medication can be organised so it all runs out at the same time, this means you will only have to put one order in.

Last Updated: 28/01/2025

  • Prescription Alignment Form

    Please complete the prescription alignment form below, this will be sent to our Pharmacist.

    Date of birth
    For example, 15 3 1984
    Please select the appropriate number of repeat medications you need to order. If you have more than 8 please detail in the text box below.

  • Privacy Policy

    This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.
    Consent
This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.