Register to Order Prescriptions Online

Please use the form below to register for online access. When you submit the form a member of our team will process your request, usually on the same day, or within 24 hours.

After our team process your request, an email will be sent to you from Patient Services (the platform used to order your prescriptions). This will contain our practice code, a linkage key and instructions for finalising your online access.

Eastfield Medical Practice, Scotland

We receive a number of contacts from patients who are contacting us about surgeries with a similar name.

Please confirm:

I intend to contact Eastfield Medical Practice in Scotland
Your Details

By submitting this form you agree to receive email and/or text message communications from us. We will only use this information to communicate with you about Eastfield Medical Practice and the service we provide.

Your name:

Your date of birth:
For example, 15 3 1984

Day

Month

Year

Your telephone number:

Your email address:

Your address:
Where would you like to collect your prescriptions?

Your preference:

Penicuik Pharmacy

Numark Edinburgh Road

Rowland's John Street

Roslin Pharmacy

West Linton Pharmacy

Text messaging reminders:

I would like to sign up for text messaging reminders

I do not want to sign up for text messaging reminders
Patient agreement

Please read the following statements and agree before continuing.

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

Yes

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

Yes

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

Yes
Personal Data

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

I consent to the practice collecting and storing my data from this form.

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Cookies on the Eastfield Medical Practice website

Register to Order Prescriptions Online

Register to Order Prescriptions Online

Eastfield Medical Practice, Scotland

Your Details

Where would you like to collect your prescriptions?

Patient agreement

Personal Data