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Introducing the Electronic Prescription Service (EPS), a new service provided by the NHS.
You can now nominate a pharmacy of your choice to receive your prescription electronically directly from your GP and have your medicines delivered to you without having to visit the pharmacy. The service is free to use, confidential and is provided via the secure NHS network. For more information please click here

Electronic Prescription Service (EPS), a new service provided by the NHS.

NHS Number, If known (Your NHS number can be found under your name and address on the top right of your prescription)

*Surgery Details

'Your surgery is not ready for Electronic Prescriptions. You can still nominate us for EPS and we will inform you once your surgery is live with the system'

Doctor Name

Do you pay for your prescription?*

No, I don't pay for my prescription Yes, I pay for my prescription

*Exemption Certificate Number

Payment Details

*Card Type

*Card Number

(With no spaces or separators)

*Card Holder Name

(Exactly as it appears on your card)

*Expiry Date

(Use MMYY format with no / or - separators e.g. 1109)

*Card Verification Number

(The last three digits printed on the signature strip on the back of your card)

*Store For Future

(Use Sage Pay Token system)

By clicking on 'register' you agree to Madesil Pharmacie taking payment for your prescription using the payment details provided.

If you prefer to nominate us on the phone please call our customer services team on 0000 000 0000.

We can improve the first time delivery success rate if, depending on the size of the package, you agree to us posting your medicine(s) through your letterbox.

I confirm my property is safe and give you consent to post medicines through my letterbox.

Some items may still require a signature on delivery, such as items that require a chilled delivery service or controlled drugs.

I understand EPS Nomination and nominate Madesil Pharmacie to collect my prescriptions on my behalf via EPS from my GP. I understand that by clicking on 'register' on this form I give consent for my prescriptions and information about my repeat medicines to be sent electronically between my doctor and Madesil Pharmacie.

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