Nomination Request

Nomination Request Form

Please complete the nomination request form below, if you wish to move your
prescriptions to one of our branches.

Pharmacy

Your Details

Tick here to opt in our free delivery service

Tick here if you have or would like your medication in weekly blister packs *note this is subject to us receiving 7 day prescriptions from your GP – one of our team members will be in contact to discuss this with you

Additional Person(s)

Please complete the sections below for any other household members who wish to register.

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Store Locations

Covingham Pharmacy Didcot Pharmacy Chinnor Pharmacy Whitton Corner Pharmacy

Pharmacy Registration Information

Superintendent Name: Mitesh Aggarwal
GPHC Registration Number: 2074489

Store Locations

SEJ Pharmaceutical Ltd, Unit 5a Caxton Trading Estate, Printing House Lane, Hayes, Middlesex, England, UB3 1BE

Company Reg No: 14359645
VAT No: 425563690

Email Address:

Email Address:

Nomination Request