<p>LAURENCEKIRK MEDICAL GROUP</p><p>Order your repeat prescriptions or make routine Doctors appointments online.</p><p>We are introducing a new service called Vision Online Services. This will let you interact with our practice using the Internet at your convenience even when we are closed.</p><p>You will need to register with the practice to access this service, and once registered you will be given information that will enable you to create your username and password. This will be on an individual basis and a form will be required for each family member. Any person over the age of 16 will require their own email address for patient confidentiality.</p><p>If you are interested in this service, please complete the form below and return it to the practice. Alternatively you can email the form back to the surgery at [email protected] . We will contact you in the near future with details of how to register. ______</p><p>Please complete your details below</p><p>First Name: ______</p><p>Surname: ______</p><p>Date of Birth: ______</p><p>Mobile Tele: (optional) ______</p><p>Email Address: ______</p><p>I would like to register for Vision Online Services which will include the practice sending text message/emails regarding clinics: </p><p>Signed:______Date:______</p>