Quick Pay Order online Name First Last Email (to receive confirmation of your request)* Enter Email Confirm Email Phone Number*Address* Street Address Address Line 2 City ZIP / Postal Code Date of Birth* Order Information*Please list any items required below. How would you like to pay for your prescription/order?*Pay onlinePay on DeliveryPlease contact the dispensary team to obtain the price of your goods on 0121 630 2680*NHS Prescription Cost is Currently £9.15 Per Item