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Online Access to Patient Services

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Application for online access to patient services so you can order and view your medication. By sending in this form you are agreeing to receive email and/or sms communications from us. We will only use this information to communicate with you about Penicuik Medical Practice and the service we provide.

Please allow 3 working days before collecting your prescription. In future you may wish to consider registering for our Online Services. The Online Services system remembers which medications you are on and makes requesting repeat prescriptions faster and easier.

By sending in this form you are agreeing to receive email and/or sms communications from us. We will only use this information to communicate with you about Penicuik Medical Practice and the service we provide.

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Patient Details

Would you like to sign up for text reminders?: *

Preferred Pharmacy: *

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Patient Consent

I wish to access the online sevices for requesting my repeat prescriptions (Please be aware that this will take 5 working days to prcoess): *

I will be responsible for the security of the information that I am given in the letter with my registration details: *

If I choose to share my information with anyone else, this is at my own risk: *

I will contact the practice as soon as possible if I suspect that my account has been accessed by someone without my agreement : *

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Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

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Online Access to Patient Services

Privacy Consent