Prescription Payment Certificate Example [Edit & Download]

Certificate Information:

• Certificate Number: PPC-2029-3210
• Issued By: National Health Service (NHS)
• Issue Date: January 1, 2029

Patient Information:

• Patient Name: Emily Thompson
• Patient ID: NHS123456789
• Address: 34 Westend Road, Springfield, SP 12345

Certificate Details:

• Type of Certificate: 12-month Prescription Prepayment Certificate
• Start Date: January 1, 2029
• Expiry Date: December 31, 2029

Payment Information:

• Amount Paid: £104.00
• Payment Date: December 25, 2028
• Method of Payment: Credit Card

Coverage:

• Coverage Details: This certificate covers all personal prescription charges for the duration of one year from the start date.

Certification:

• This certificate confirms that Emily Thompson has paid for a 12-month Prescription Prepayment Certificate, which covers all prescribed medications required during the period. This ensures cost savings and simplifies the management of regular medication needs.

Authorized Signatory:

• Name: Dr. Susan Clarke
• Position: Head of Pharmacy Services
• Signature: [Signature Dr. Susan Clarke]

Additional Notes:

• Instructions: The holder of this certificate is entitled to receive all prescribed medications without additional charge at any participating pharmacy. It is advisable to keep this certificate readily available when visiting pharmacies to avail of the covered benefits.
• Remarks: For any changes in prescription needs or personal details, please contact NHS Services to ensure your records are up-to-date and to avoid any disruptions in medication supply.

Contact Information:

• Health Service Contact: Phone: (800) 555-0199, Email: prescriptions@nhs.uk