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You will need to complete an FP34PD Opt Out Form.
 
You should contact our helpline to arrange for a form to be sent out.
 
Telephone: 0300 330 1349 or 0191 279 0568 
 
Webform: Use our online webform

Email: nhsbsa.prescriptionservices@nhsbsa.nhs.uk
 
Please note that you can also use this form to opt back in to receiving the form if you need it in the future.