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Query my Pharmacy Medication?
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01952 460414
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Pharmacy Medication Query
Required fields are marked with an asterisk (*).
Date
**PLEASE NOTE
– This is a query form for Pharmacist use ONLY. If completed by a Patient, this form will not be processed**
Patients MUST contact
POD
(Prescription Ordering Direct) on
0333 358 3509
(8am-5pm) or email them at
shropshire.pod@nhs.net
(8am-5pm).
Please be advised that POD is not part of Shifnal & Priorslee Medical Practice.
Pharmacy Name
*
Pharmacy Email address for response
*
Pharmacy Contact Name
*
Telephone number
*
Please complete the patient details below
Patient’s Name
*
Date of Birth
*
NHS No.
*
Medication Name
*
How can we assist you?
*
*Please make sure all Mandatory fields have been completed
*
Privacy Consent
This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data
*
I consent to the practice collecting and storing my data from this form
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*
Send
This field should be left blank
Other forms available
Register as Patient
Please visit our Patient Registration page and fill in the health questionnaire to register as a patient at Teldoc.
Change of Address
Please visit our Change of Name Form to update your details
Provide Feedback
Please visit our Feedback Form to provide feedback, make a suggestion or complaint.
More forms
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