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Your Details

We just need a few personal details to create your online account.

Online Account Details

An online account will enable you to update your details quickly and easily:

Doctor Details

It would be helpfull to know the GP of the patient, so please enter the postcode below.

Don't worry if you don't know the post code of your GP, you can skip this section if you want.:


Service Options

Details of how you would like to receive your delivery.

Delivery Options


Payment & Exceptions

Details of how you pay for your prescriptions.

Agreement

I am the patient named in this registration form.

Nomination has been explained to me and a leaflet is available that explains nomination.

I would like to name Harrogate Pharmacy as my nominated pharmacy for dispensing my prescriptions.

By agreeing to this form you give us authority to access your Summary Care Record and to discuss your care with your GP.

Patient Details

Details of the patient so we can register them for the service.