Online Prescription Ordering

* Email

* First Name

* Last Name

Mobile Number

Address

GMS Number

DPS Number

Is this a new or repeat prescription? -- Please Select -- New Repeat

Dispense all medicines? -- Please Select -- Yes No

Collection Location -- Please Select -- Waterford Health Park Waterford Primary Care Centre Tullamore

NEW PRESCRIPTIONS ONLY: Submit a photo of your subscription (e.g. take a photo from your mobile phone and upload it)

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