test form


Pharmacy Prescription Order Form (TESTING)

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 February 2024

MON TUE WED THU FRI SAT SUN
1234
567891011
12131415161718
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26272829
Max. file size: 2 MB.

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