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DISCLAIMER - PLEASE READ

To use this system, you will have to enter information about yourself that will be sent to us across the internet.
This e-form information is not encrypted, but will be no less secure than a normal email.
We can not guarantee that this information will not be seen by others.
I confirm that I wish to use the Repeat Prescription Ordering Online Service provided by Shaftesbury Medical Practice and confirm that I have read and accept the disclaimer above.  Please select the Yes option in the box below if you agree to these terms.

 

 

  
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  e.g. Paracetamol   e.g. 500mg   e.g. 100 tablets    
   

     
         
         
         
         
         
         
         
         
         
         
         
               
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