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Meningitis A,C,W, and Y
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Nominating Kiveton Pharmacy I understand the service provided by Kiveton Pharmacy and would like to register to use them. I understand the EPS nomination process and would like to nominate Kiveton Pharmacy to collect my prescriptions on my behalf direct from my GP or via EPS. I give permission for my prescriptions to be sent between my GP and Kiveton Pharmacy. If you are joining Kiveton Pharmacy on behalf of somebody you confirm that you are authorised to act on behalf of the patient and consent to their information being used as stated in this form. We respect your privacy and as such, Kiveton Pharmacy will only use your information for the purposes stated above.
Unit 20 Holroyd business centre, Carrbottom road, Bradford West Yorkshire BD5 9BP