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First Name*

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Yes I would like to nominate Pharmacy To My Door for EPS

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A password must consist of minimum length of 8 characters. Including minimum 3 classes of characters (Lower Case, Upper Case, Digits, Special Characters). Leading and trailing spaces will be ignored.

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Additional Information

Electronic Prescription Service

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.

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

Find your surgery

Please enter your postcode to find your surgery*

Doctor Name

Do you pay for your prescription?*

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

If you prefer to nominate us on the phone please call our customer services team on 0330 606 1444.

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.

Exempt type*

A: is under 16 years of age

B: is 16,17 or 18 and in full time education

C: 60 years of age or over

D: has a valid maternity exemption certificate

E: has a valid medical exemption certificate

F: has a valid prescription pre-payment certificate

G: has a valid War Pension exemption certificate

H: gets, or has a partner who gets Income Support or income related allowance

K: gets, or has a partner who gets Income based Jobseekers allowance

L: is named on current HC2 charges certificate

M: is entitled to, or named on, a valid NHS Tax Credit Exemption Certificate

S: has a a partner who gets Pension Credit guarantee credit (PCGC)

X: was prescribed free-of-charge contraceptives

*Exemption Expiry Date

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 'sign up' you agree to Pharmacy To My Door taking payment for your prescription using the payment details provided.

Post medicines through my 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 Pharmacy To My Door to collect my prescriptions on my behalf via EPS from my GP. I understand that by clicking on 'sign up' on this form I give consent for my prescriptions and information about my repeat medicines to be sent electronically between my doctor and Pharmacy To My Door.

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