(XRP HEALTH LTD) Nomination Registration Form

I would like to nominate LetterBoxPharmacy.com (XRP Health LTD) and give full authority to handle my acute/ repeat prescription, which includes the delivery of my medication. I understand this is an online pharmacy, therefore any essential services, such as collection of medication is prohibited, and therefore I authorise delivery of my medication.

I would like to opt-in for: (unless crossed off below)

  • Email marketing (inc. Goods, services, other).
  • Telephone Marketing
  • Postal Marketing
  • Video marketing
  • SMS messaging (marketing and notifying of delivery)

if am not in, please:

My details are



Mobile Number:

Please print and send to 20 Spelman Street, London, E1 5LQ