Prescription question

Named GP (if known):

What is your prescription question?

Would you like us to send you text messages?

Yes

No

Please note that the details you give will be used to update your medical records.

Confirmation

I confirm that my enquiry is not urgent, and it may take up to 2 working days before I receive a reply.

I confirm that I am registered at The White House Surgery, MORETON-IN-MARSH, Gloucestershire. If not, I will send to the correct surgery.

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