Pharmacy Contractor Questionnaire (PNA 2025) - Page 1 of 6 - Slough Borough Council

Page 1 of 6

Premises and Contact Details

1. Pharmacy Name:

(Required)

2. Full Address:

(Required)

3. Postcode:

Enter your Postcode (Required)

4. Primary Contact Name:

(Required)

5. Primary Contact Email:

Enter your email address (Required)

6. Primary Contact Number:

Enter your Number (Required)

7. Is this pharmacy a 100-hour pharmacy?

(Required) Yes No

8. Do you have the capacity to extend your opening / closing hours if required?

(Required) Yes No

9. If "Yes" Kindly list potential days and times for extension?