Prescription Ordering Form

Please select which Surgery you attend from the list.
DD slash MM slash YYYY
Address(Required)
Required to receive a text message to inform you when your Prescription is ready for collection.
Prescription items required(Required)
Item Name
Quantity
Strength
 
Permission(Required)
Marketing
We may, at times, contact you with information about our services (for example when flu vaccinations become available). This contact will be infrequent and your contact details will not be shared. If you would prefer that we did not offer this service, please tick this box.

Get in touch!

Bargoed Pharmacy
9 Cardiff Road,
Bargoed,
Caerphilly,
CF81 8WZ,

Phone/ Fax Number: 01443 839983
Email: enquiries@bargoedpharmacy.co.uk