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Have your electronic prescriptions sent to RiteCare

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Electronic prescription nomination form

Complete this form to sign-up

Please complete this form to sign up to our prescription delivery service, ensuring that all the information is entered accurately. By filling in this form you are asking your doctor to send all your electronic prescriptions to RiteCare Pharmacy. You can change this nomination at any time.










    GP Name:

    GP Address:

    Do you wish to have your prescriptions dispensed into blisterpacks ( please note there is a £10 per month charge for this service, see our 'blisterpack page' for more information)

    By ticking this box you are consenting to your future prescriptions being sent electronically to RiteCare Pharmacy. We will then dispense your prescriptions and deliver them to you. You can change this nomination at any time.