Pharmacy Consultation: Allergic Reaction

Please complete this form if you would like to arrange a face-to-face consultation with your local pharmacist. Once the form is complete please call the pharmacy that you have selected to arrange the best time to visit. This should be done on the same day you complete this form.

*Please note this service is only in operation based on pharmacy opening hours

Birk & Nagra 170 Rugby Rd Milverton: 01926426863

Boots the Chemist 31 The Parade: 01926 424945

Boots the Chemist 37-39 Oxford St: 01926 887268

Hb Dunn Chemist 31-33 Oxford St: 01926 424796

Lillington Pharmacy 100 Cubbington Rd: 01926 426124

Lloyds Pharmacy 51 Clarendon Street: 01926 336568

Lloyds Pharmacy 51 Crown Way: 01926 423582

Lloyds Pharmacy Shire Retail Park: 01926 881701

Superdrug Pharmacy 88-90 The Parade: 01926 450953

Don't know your NHS number?

Allergic reaction: Advice & Information page

Please note that some allergic reactions can be life-threatening. If you have any lip or tongue swelling, difficulty breathing or noisy breathing then you must call 999 for urgent medical assistance.

Pharmacy Consultation: Allergic Reaction

Patient Name:

Date of Birth (DD/MM/YYYY):

NHS numberPlease complete If known

Contact number:

Email address:

Please select the pharmacy where you would like to have your face-to-face consultation

I confirm I do NOT have any of the symptoms listed above in red

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