Before you begin, please confirm the three boxes below. Please allow up to 2 working days for us to process your prescription request. Please note, if you have not been seen by London Gynaecology in the last 12 months, you will need to make an appointment and see one of our consultants before using this service.

Please make sure the registered billing address of your card is entered under “Personal Details”

I confirm I have taken the medication I am requesting previously

I confirm I have been seen at London Gynaecology in the last 12 months

There will be an administrative charge of £25. (Kindly note, this is separate from the pharmacy charge)

Personal Details:

Date of Birth *

Add a different billing address

NOTE: You may enter a non-UK address for registration and billing, but delivery is UK only, so you must enter an alternate UK delivery address below, or nominate a UK pharmacy.

Request Details:

Do you have any allergies? *

How would you like your prescription to be shared? *

Deliver to a different address than the one above

Please provide a mobile number to be contacted on.

Please provide either an email address or fax number of the pharmacy.

Please note, if the prescription is sent to your pharmacy we will also post a signed copy.

I agree to the Terms and Conditions and Website Privacy Policy

I request that you begin supply of your service before the end of the 14-day statutory cancellation period and I acknowledge that I lose the right to cancel once the contract has been fully performed