Precription Requests at Kings Lane Medical Practice

If you are taking regular medication, you can order your prescriptions on this page.
You can order up to 6 different prescription items at a time - use the form repeatedly if you need to order more than 6 items.

Privacy Warning

This message is sent through the standard internet email service. Many of you will know that standard
internet email is not a secure way to exchange messages. For this reason, this form only sends the first
three letters of your surname & first name. Please do not include your address anywhere in your
messages and please do not include any very personal or sensitive detail in your message.

Please DO NOT ask for medical advice by email, this contact us page is administrative advice only;
eg progress of referrals, advice around test results

What is your unique practice number ?

(Find it on the top right of your prescription counterfoil)

Or, enter the 1st three letters of your
surname & first name

Surname First Name

(required only if you do not know your unique practice number)

Your date of birth

Your email address

How will your prescription be collected?

I will collect it from the surgery I will ask my local pharmacy to collect it Please use my SAEs to send the prescription *

1 )

2 )

3 )

4 )

5 )

6 )

Please enter the following characters in the box below

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