By signing up for the services, you agree to the following:
You understand PCH Chemist’s services and wish to register for their use. You understand the Electronic Prescription Service and wish to
appoint PCH Chemist as your designated pharmacy for the dispensing of electronic prescriptions.
You would like PCH Chemist to retain your repeat slips to reorder your prescription from our pharmacy and collect your prescriptions from
your surgery on your behalf, either in person or by means of electronic transfer.
You agree to allow PCH Chemist to contact you and/or your surgery by post, phone or by electronic means to verify prescription contents.
If you are affirming that the patient does not have to pay NHS prescription charges, that patient must be suitably entitled to an exemption
and that the information provided is true and complete.
You further affirm that should the patients’ entitlement change, you will inform PCH Chemist immediately on 0191 916 0040, and
understand that in not doing so appropriate action may be taken.
PCH Chemist respects your privacy and any personal information you provide on this form will be treated confidentially and retained securely
in our computer system.