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Form – Express Prescription Collection Locker Request Form
Collection Locker Form
NOTE: There may be some medicines which may not be suitable to be collected from 24/7 Collection Lockers such as controlled drugs, refrigerated or bulky items.
Select your local Pharmacy
Branches
(Required)
Please Select
Arbroath - 59 Keptie Street
Banchory - 61-63 High Street
McPhersons - 120 - 122 Gray Street, Broughty Ferry
Milnathort - 8-10 New Road
Scone - 11-13 Angus Road
Please Select
Are you currently registered with this pharmacy for our prescription collection service?
(Required)
Yes
No
Prescription Collection
We offer the convenience of collecting your prescription directly from your GP surgery and notifying you when it's ready for collection from our express collection locker. Simply provide us with your surgery details, and we will organise this for you.
Would you like to register for our prescription collection service?
(Required)
Yes
No
Surgery Name
(Required)
My GP is Dr:
Personal Details
Name
(Required)
Title
Dr.
Miss
Mr.
Mrs.
Ms.
Mx.
Prof.
Rev.
First Name
Last Name
Address
(Required)
Street Address
Address Line 2
City
Postcode
Date of Birth
(Required)
Day
Month
Year
Email
You must provide us with your mobile number as it is required to send an SMS text message with a unique PIN number each time you have a prescription ready for uplift from the 24/7 Collection Locker. This service does not offer a reply facility to enable patients to respond to texts directly.
Mobile Phone Number
(Required)
Mobile Number Owner (if different)
(Required)
If the mobile number provided is not registered to the patient, please enter the name of the account holder and their relationship to the patient.
To use our 24/7 Prescription Lockers, we need your mobile number to send a PIN when your prescription is ready.
(Required)
I consent to Davidsons Chemists collecting and processing my prescription, making it available via the 24/7 Prescription Collection Locker, and contacting me by text regarding my medication. I will inform the pharmacy if my mobile number changes.
I consent to my prescriptions being stored in the locker and to receiving text messages. I will inform the pharmacy if my mobile number changes.
Comments
This field is for validation purposes and should be left unchanged.
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