Reserve & Collect

Welcome to our Reserve and Collect Prescription service. If you have a current prescription on file in Rosslare Pharmacy feel free to fill out the form below. Alternatively, if its a new prescription and you have a copy of it you can upload it below and we will get your prescription ready for you to collect at your convenience. Please note, we do need you to bring in the original script so that we can endorse it.

First Name*  

Last Name*  

Address*  

Email Address*  

Home Telephone No:  

Mobile Telephone No*:  

Which items on your repeat prescription would you like to order?

  • to order ALL of the items listed on your prescription, simply type ALL in the box below
  • to order certain items listed on your prescription please list each item in the box below

Prescription Items  

Comments  

If you have a copy of your script please upload here by the browse button