"*" indicates required fields

Step 1 of 2

50%
Add your personal details below. Please enter the details your GP will have on record so we can match you to your GP.
Name*
Date of birth*
Address*
Enter postcode, surgery name or town to search OR select GP surgery not listed
Enter details above
How would you like to get your prescriptions?*
How would you like to order?*
Please enter one medication per line
Accepted file types: jpg, png, gif, webp, tiff, psd, raw, bmp, heif, indd, jpeg, Max. file size: 10 MB.
Upload repeat slip
I agree to make Capsule Pharmacy my chosen pharmacy. This means Capsule Pharmacy retain my repeat prescription re-order slip, request prescriptions from my surgery and collect prescriptions on my behalf either in person or by electronic transfer.