To Take Away (TTA) Prescription Request

Patient Details

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INITIALS *

Planned Discharge Date

Known Allergies and Drug Chart

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Penicillin and related antibiotics

Aspirin, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs)

Other, please specifyOther, please specify

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Requesting Ward Staff

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Ear, Nose, & Throat

Vaccinations

Lifestyle

Skin

Women's Health

Infections & Minor Illness

Weight Management

Menopause

Family Planning

Hair Loss

Aesthetics

Earwax Removal

Mole Check

Cryotherapy

Vitamin B12 Treatment

Blood Pressure Check

Private GP Services

Travel Vaccination Clinic

Flu Vaccination

COVID-19 Vaccination

HPV

Hepatitis B

Pneumococcal Vaccine

Chickenpox

Yellow Fever Vaccination

Book Appointment

Pricelist

Contact

NHS Services

Shingles Rash

(18+)

Impetigo Sores

(1+)

Urine Infection

(Women 16-64 Yrs)

Ear Infection

(1-17 Years)

Sinusitis

(12+)

Sore Throat

(5+)

Infected Bug Bites

(1+)

Contraceptive Pill Repeat Supply

NHS Stop Smoking Support

NHS Cardiovascular Heath Check

Private Services

Erectile Dysfunction Treatment

Period Delay

Cardiovascular Heath Check

Weight Loss Pre-Assessment

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To Take Away (TTA) Prescription Request

Patient Details

Known Allergies and Drug Chart

Requesting Ward Staff