Medication Queries Medication Queries Declaration(Required) I understand that this form is for medication queries only and should not be used to submit repeat medication requests; these requests should be submitted via your online account or by contacting the Dispensary on 01778 579000 Name(Required) (of Patient)Date Of Birth(Required) (of Patient)EMIS Number (if known) Query Priority(Required) Urgent Query (Please allow 2 working days) Non-Urgent Query (Please allow 5 working days) If your query needs immediate attention please contact the dispensary on 01778 579000Preferred Method Of Contact For Response(Required)Please enter the best number or email for us to reply to your enquiry on Comments