Free Prescription Delivery

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Send your Delivery Registration to Upper Rissington by completing the form below. * indicates a required field.

Tell us about you:
Tell us about your doctor:
Additional Information:

In order that we can dispense your medication we require the following information to locate your record on the NHS database:

Declaration:
  • By requesting access to the free delivery service you agree to nominate Badham Pharmacy to dispense your prescription medication.
  • I understand that the delivery service is not NHS funded and is provided free of charge by Badham Pharmacy Ltd.
Additional Notes: