Home How It Works Free sample FAQs Order form About us Contact us Fill in this short online form and we will contact you within 24 hours to arrange the free service. Alternatively, you can call us on 0800 1123147 to arrange over the phone. Title: Mr Mrs Ms Miss Dr * First Name * Surname Email Address * Address Postcode * Daytime Tel Mobile Date of Birth (DD/MM/YY) Do you normally pay for your prescriptions? Yes No Your Doctor's Name Doctor's Surgery Telephone Doctor's Surgery Address Where did you hear about Pillbox UK? I authorise Pillbox UK to contact my GP on my behalf to discuss issues relating to my medication. CAPTCHA Please enter the text to the right exactly as shown