Croyard Surgery prescription preference form

Croyard Surgery prescription preference form

This form will allow you to specify how your prescription is handled once issued by the surgery. You can request to pick up your prescription from either of our practice sites, or for one of our local pharmacies to collect and process this so you can collect it directly from the pharmacy.

Please allow 5 working days for any changes to be applied. 

If you require medications to be delivered you will need to discuss this directly with your pharmacy

  • Your Details

    Please complete your details below

    Date of Birth
    For example, 15 3 1984
    Select where you would like your prescription to be sent
    I consent to Croyard Medical Practice collecting and storing the above data in order to update my records and to process this request
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Page last reviewed: 04 February 2026
Page created: 04 February 2026