Nominate A Pharmacy - Waterfront Medical Centre

When you request your medication, you can have your prescription sent to a pharmacy of your choice. This is called a nomination.

Once you have nominated a pharmacy:

you will no longer need to collect paper prescriptions from the practice.
your nominated pharmacy will receive your prescriptions until you tell us to change or remove your nominated pharmacy.

You can nominate a local pharmacy by either:

Completing the form below.
filling in the nominate a pharmacy form at reception.

Personal Details

Full Name

Date of Birth

Address

Contact Number

Further Information

Enter your chosen pharmacy below. Please ensure your pharmacy provides the 'nominate your pharmacy' service before continuing.

Are you happy for us to update your records with your selected pharmacy?

Yes

Consent

This form collects your name, date of birth, other personal information and medical details. This is to confirm you are registered with the practice, to allow Waterfront Medical Centre to contact you, and to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy for more information on how we protect and manage your submitted data. I consent to Waterfront Medical Centre collecting and storing my data submitted via this form.