test form


Pharmacy Prescription Order Form (Current)

Need a Prescription? Simply Order Below For Collection.

Please keep in mind the current time when selecting a collection time and do not select a collection time if the current time falls within it, e.g.:
If it is 11.45am and you select 9.30am -12pm it will not be ready in time, please select the next collection time.

Timezone: Europe/Dublin December 2024

MON TUE WED THU FRI SAT SUN
1
2345678
9101112131415
16171819202122
23242526272829
3031
Max. file size: 5 MB.

If this is a NEW prescription please bring the original prescription with you