Prescription Collection FormPrescription Collection To McPhersons Pharmacy Please collect my repeat prescriptions from my GP's surgery. I will advise you if I want to change this arrangement.Surgery DetailsMy GP is Dr:*Surgery namePractice NameABBEY HEALTH CENTREABERCHIRDER MEDICAL PRACTICEABERFELDY AND KINLOCH RANNOCH MEDICAL PRACTICEABERFOYLE MEDICAL CENTREABERLOUR HEALTH CENTREABOYNE HEALTH CENTRE INCL. TARLANDACADEMY MEDICAL CENTREAIRLIE MEDICAL PRACTICEAIRTHREY PARK MEDICAL CENTREALBYN MEDICAL PRACTICEALFORD MEDICAL PRACTICEALLAN PARK MEDICAL PRACTICEALVA MEDICAL PRACTICEALYTH HEALTH CENTREANCRUM MEDICAL CENTREANCRUM MEDICAL CENTREANNAT BANK PRACTICEANSTRUTHER MEDICAL PRACTICEANTONINE MEDICAL PRACTICEARBROATH MEDICAL CENTREARDACH HEALTH CENTREARDBLAIR MEDICAL PRACTICEARK MEDICAL PRACTICEATHOLL MEDICAL CENTREAUCHENBLAE MEDICAL CENTREAUCHTERMUCHTY PRACTICEBALFRON HEALTH CENTREBALLATER CLINICBANCHORY GROUP PRACTICEBANFF AND GAMRIE MEDICAL PRACTICEBANK STREET MEDICAL GROUPBANNOCKBURN HEALTH CENTREBELLYEOMAN SURGERYBENNOCHY MEDICAL CENTREBLACKFRIARS MEDICAL PRACTICEBO'NESS ROAD MEDICAL PRACTICEBONNYBANK MEDICAL PRACTICEBRACKLINN PRACTICEBRAEMAR HEALTH CLINICBRAESVIEW MEDICAL GROUPBRECHIN MEDICAL PRACTICEBRIDGE OF ALLAN HEALTH CENTREBRIDGE OF EARN SURGERYBRIMMOND MEDICAL GROUPBROUGHTY FAMILY HEALTHCAREBUCHLYVIE SURGERYBUCKSBURN MEDICAL PRACTICEBYDAND MEDICAL GROUPCALSAYSEAT MEDICAL GROUPCAMELON MEDICAL PRACTICECAMPHILL MEDICAL PRACTICECARDEN MEDICAL CENTRECARNOUSTIE MEDICAL GROUPCARRON MEDICAL CENTRECARRONBANK MEDICAL PRACTICECASTLEGAIT SURGERYCENTRAL BUCHAN MEDICAL PRACTICECLACKMANNAN & KINCARDINE MEDICAL PRACTICECOLDSIDE MEDICAL PRACTICECOMRIE MEDICAL CENTRECOS LANE SURGERYCOUPAR ANGUS MEDICAL CENTRECOUPAR ANGUS MEDICAL CENTRECOWDENBEATH SURGERYCRAIGVINEAN SURGERYCRIMOND MEDICAL CENTRECROSSGATES MEDICAL PRACTICECRUDEN MEDICAL GROUPCULTS MEDICAL GROUPCUMINESTOWN MEDICAL PRACTICEDANESTONE MEDICAL PRACTICEDENBURN MEDICAL PRACTICEDENNY CROSS MEDICAL CENTREDEVERON MEDICAL PRACTICEDOLLAR HEALTH CENTREDOUNE HEALTH CENTREDOWNFIELD SURGERYDR ANDERSON & PARTNERSDR BORLAND & PARTNERS CCHCDR C M MACGLONEDR C WHITELAW & PARTNERSDR CHANDR HITCHCOCK'S PRACTICEDR K THOMPSONDR KYLE & PARTNERSDR MCLAREN & PARTNERSDR STEPHEN BROWNDR STIRLING & PARTNERSDRS BANDULARATNE, FLEMING, REES & WHEALDRS BEE, DUFFY, MCGOWAN, LINDSAY & STARBUCKDRS BLYTH, BURNETT, DOW, HARGREAVES & MACDONALDDRS BOGGON & HALFORDDRS DIXON, DUGGAN, EGERTON, FLYNN & MCCRICKARDDRS MCKEAN & LIMDRS MITCHELL, MORRIS & FORDYCEDRS PAGE, CLARK & MCDONALDDRS ROBSON, CARLIN & BROWNDRYMEN HEALTH CENTREDUNBLANE MEDICAL PRACTICEEAST PRACTICE, SPRINGFIELD MEDICAL CENTREEDENKILN SURGERYEDZELL HEALTH CENTREELGIN COMMUNITY SURGERYELLON GROUP PRACTICEELMBANK GROUP PRACTICEERSKINE PRACTICEFALLIN HEALTH CENTREFAMILY MEDICAL GROUPFEDDINCH MEDICAL PRACTICEFINLAYSON STREET PRACTICEFOCHABERS MEDICAL PRACTICEFORRES HEALTH CENTREFORTHVIEW PRACTICEFRIOCKHEIM HEALTH CENTREFYVIE OLDMELDRUM MEDICAL GROUPGARTHDEE MEDICAL GROUPGILBERT ROAD MEDICAL GROUPGLENLIVET MEDICAL PRACTICEGRAEME MEDICAL CENTREGREAT WESTERN MEDICAL PRACTICEGREEN PRACTICE, WHITEFRIARS SURGERYGROVE HEALTH CENTREHADDO MEDICAL GROUPHAMILTON MEDICAL GROUPHAWKHILL MEDICAL CENTREHEALTH CENTRE PRACTICE 2HILLBANK HEALTH CENTREHOLBURN MEDICAL GROUPHOSPITAL HILL SURGERYHOWE OF FIFE SURGERYINSCH MEDICAL PRACTICEINVERBERVIE MEDICAL GROUPINVERGOWRIE MEDICAL PRACTICEINVERKEITHING MEDICAL GROUPINVERURIE MEDICAL GROUPINZIEVAR MEDICAL PRACTICEKEITH MEDICAL GROUPKELTY MEDICAL PRACTICEKEMNAY MEDICAL GROUPKENNOWAY MEDICAL GROUPKERSIEBANK MEDICAL PRACTICEKILLEARN HEALTH CENTREKILLIN MEDICAL PRACTICEKINCORTH MEDICAL PRACTIICEKINGHORN MEDICAL PRACTICEKINGLASS MEDICAL PRACTICEKINGS PRACTICEKINLOSS MEDICAL CENTRE (ARMY)KIPPEN SURGERYKIRRIEMUIR MEDICAL PRACTICELAURENCEKIRK MEDICAL GROUPLENY PRACTICELESLIE MEDICAL PRACTICELINBURN ROAD HEALTH CENTRELINKS MEDICAL PRACTICELINKWOOD MEDICALLOCHEE HEALTH CENTRELOCHGELLY MEDICAL GROUPLOUR ROAD GROUP PRACTICEMACDUFF MEDICAL PRACTICEMARKINCH MEDICAL PRACTICEMARYFIELD MEDICAL CENTREMARYHILL GROUP PRACTICE INCL. ROTHESMARYWELL HEALTHCARE CENTREMAUVE PRACTICE, DRUMHAR HEALTH CENTREMEEKS ROAD SURGERYMETHILHAVEN SURGERYMILL PRACTICEMILLHILL SURGERYMINTLAW GROUP PRACTICEMONIFIETH HEALTH CENTREMORAY COAST MEDICAL PRACTICEMUIREDGE SURGERYMUIRHEAD MEDICAL CENTRENETHERGATE MEDICAL CENTRENETHERTOWN SURGERYNEW PARK MEDICAL PRACTICENEWBURGH SURGERYNICOL STREET SURGERYNORTH GLEN MEDICAL PRACTICENORTHFIELD/MASTRICK MEDICAL PRACTICEOCHILVIEW PRACTICEOLD ABERDEEN MEDICAL PRACTICEOLDMACHAR MEDICAL PRACTICEORCHARD HOUSE HEALTH CENTREORWELL PRACTICEPARK AVENUE MEDICAL CENTREPARK AVENUE MEDICAL CENTREPARK ROAD PRACTICEPARK TERRACE MEDICAL PRACTICEPARKVIEW PRACTICEPATH HOUSE MEDICAL PRACTICEPETERCULTER MEDICAL PRACTICEPETERHEAD HEALTH CENTREPITCAIRN PRACTICE LEUCHARS & BALMULLOPOLMONT PARK MEDICAL PRACTICEPORTLETHEN MEDICAL CENTREPORTSOY MEDICAL PRACTICEPRIMROSE LANE MEDICAL CENTREPRINCES STREET SURGERYRAVENSWOOD SURGERYRED PRACTICE, WHITEFRIARS SURGERYRHYNIE SURGERYRINNES MEDICAL GROUPROSEMOUNT MEDICAL GROUPROTHES MEDICAL PRACTICERUBISLAW PLACE MEDICAL GROUPRYEHILL MEDICAL PRACTICESALTOUN SURGERYSCOTSTOWN MEDICAL GROUPSEAFIELD & CULLEN MEDICAL GROUPSKENE MEDICAL GROUPSLAMANNAN MEDICAL PRACTICEST MARGARET'S HEALTH CENTREST NINIANS MEDICAL PRACTICEST SERF'S PRACTICESTANLEY MEDICAL CENTRESTATION HEALTH CENTRE RAF LOSSIEMOUTHSTENHOUSE PRACTICESTOBSWELL MEDICAL CENTRESTONEHAVEN MEDICAL GROUPSTRATHCAIRN MEDICAL PRACTICESTRATHCARRON HOSPICESTRATHDON MEDICAL CENTRESTRATHMORE SURGERYTAY COURT SURGERYTAYBANK MEDICAL CENTRETAYVIEW MEDICAL PRACTICETERRA NOVA MEDICAL PRACTICE LLPTHE BLUE PRACTICETHE CANNONS PRACTICETHE CARSE MEDICAL PRACTICETHE GLENWOOD PRACTICETHE LOMOND PRACTICETHE MEDICAL CENTRETHE RED PRACTICETHE RICHMOND PRACTICETHE TAYMOUNT SURGERYTHE WALLACE MEDICAL PRACTICETILLICOULTRY MEDICAL PRACTICETORPHINS MEDICAL PRACTICETORRY MEDICAL PRACTICETOWNHEAD PRACTICETRYST MEDICAL CENTRETURRIFF MEDICAL PRACTICEVALLEYFIELD MEDICAL PRACTICEVARIS MEDICAL PRACTICEVICTORIA PRACTICEVICTORIA STREET MEDICAL GROUPVIEWFIELD MEDICAL PRACTICEVIEWPOINT MEDICAL PRACTICEWALLACE MEDICAL CENTREWALLSGREEN MEDICAL PRACTICEWEST PRACTICE, SPRINGFIELD MEDICAL CENTREWESTBURN MEDICAL GROUPWESTBURN MEDICAL PRACTICEWESTGATE MEDICAL PRACTICEWHINHILL MEDICAL PRACTICEWHITFIELD SURGERYWOODSIDE MEDICAL GROUPYELLOW PRACTICE, DRUMHAR HEALTH CENTREPersonal DetailsTitleMrMrsMissMasterMsDrRevOtherFull Name*Address* Street Address Address Line 2 City County / State / Region ZIP / Postal Code Date of Birth* DD MM YYYY Email* Phone*Text Messaging Service Patient ConsentMcPhersons Pharmacy may contact you by SMS to notify you about your prescriptions, such as when it is ready for collection Under no circumstances will your phone number or prescription details be shared with any party outside McPhersons Pharmacy, and no details of your medication will be included in the text message. McPhersons Pharmacy will only text you in relation to your prescription and will not text you for any marketing purposes. This service does not offer a reply facility to enable patients to respond to texts directly.Contact via Text Message* Yes NoI give my permission to the staff at McPhersons Pharmacy to contact me by Text Message for the reasons stated above. I confirm that I will advise the pharmacy if I change my mobile number. Text messages are generated using a secure facility and I understand that they are transmitted over a public network onto a personal telephone which may not be secure. Please note for data protection you may only sign up on a personal mobile number, not family members.Name of account holder for mobile phoneI confirm this is my own personal mobile phone and understand that I cannot receive messages regarding prescriptions for a family member.CAPTCHACommentsThis field is for validation purposes and should be left unchanged. 44117