STACKS PHARMACY DIRECT DEBIT

Take the hassle out of remembering to pay your bills.
Stacks Pharmacy Direct Debits are automatic payments you can set up to pay regular bills by varying or fixed amounts.
Please download our direct debit pdf, fill it out and attach it to the application form below.

Patients's Name Patient's Care Home Payers's Name Payers E-mail Payers Phone Amount Attach scan/photo of Direct debit mandate (formats accepted: pdf,jpeg,jpg | Max size: 2mb)
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