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Order Summary

Item
Unit
QTY
Cost
[% item.nhs_prescription_item.name %]
[% item.item_name %]
[%% addition.html %%]
Subscription included
(every )
[%% item.original_price | multi_currency %%] [%% item.item_price | multi_currency %%]
[% item.nhs_prescription_item.quantity %]
[% item.quantity %]
[%% item.original_total|multi_currency %%] [%% item.line_total|multi_currency %%]
[% item.stock_error %]
[%% item.delivery_error %%]
[% discount.discount_name %] - [%% discount.discount_amount|multi_currency %%]
Sub total [%% basket.cost_subtotal|multi_currency %%]
[% errors.coupon_error %]
[% messages.coupon_success %]
[% basket.coupon_message %] -[%% basket.coupon_deduct|multi_currency %%]
[% basket.coupon_message %] -[%% basket.coupon_deduct|multi_currency %%]

Unfortunately we are unable to post prescription medication to your country. Please see the delivery page for further information [% current_delivery_name %]

[%% basket.cost_delivery|multi_currency %%] FREE

[%% errors.delivery %%]

Total [%% basket.cost_total|multi_currency %%]
[% errors.blacklisted %]

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Patients Details
Please enter your first and last name exactly as it appears on your ID. This is to allow an ID verification. Read More
[% errors.address.billing.gender %]
[% errors.address.billing.firstname %]
[% errors.address.billing.middlename %]
[% errors.address.billing.lastname %]
[% errors.info.email %]
[% messages.account_verifier.email.sent %]
[% errors.account_verifier.email %]
[% messages.account_verifier.email.verified %]
[% errors.cardholder_password %]
[% errors.info.dob %]
ID Check

Unfortunately your identity could not be verified using given data. Please fill out the additional information to confirm your identity.

[% errors.info.id_type %]
Example:107185702 2 GBR 8501178 F 1601312 <<<<<<<<<<<<<< 02
Example:MORGA 753116 SM9IJ
Example:ID GBR 1234567897 <<<<<<<<<<<<<<< 7704145 F 1604117 GBR <<<<<<<<<<< 4
[% errors.info.id_number %]

The ID number you have entered appears to be incorrect. Please ensure you have entered the number exactly as it appears on your ID.

Please use the "Where can I find this" link above for help finding the ID number.

Billing Details
Please enter your billing address. This is the one which is linked to your bank account and allows us to complete your ID check. You can add a different delivery address below
Phone number*
[% errors.info.contact_no %]
[% errors.info.phone_prefix %]
[% messages.account_verifier.phone.sent %]
[% errors.account_verifier.phone %]
[% messages.account_verifier.phone.verified %]
[% errors.address.billing.postcode %]
[% errors.address.billing.address1 %]
[% errors.address.billing.address2 %]
[% errors.address.billing.city %]
[% errors.address.billing.country %]
[% errors.address.billing.state %]
Alternative Delivery Details (Optional)
[% errors.address.shipping.gender %]
[% errors.address.shipping.firstname %]
[% errors.address.shipping.lastname %]
[% errors.address.shipping.postcode %]
[% errors.address.shipping.address1 %]
[% errors.address.shipping.address2 %]
[% errors.address.shipping.city %]
[% errors.address.shipping.state %]
[% errors.address.shipping.notes %]
[% errors.terms %]
[% empty_basket_message %]