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Completing the WP34C

The WP34C has 3 separate sections. These are –   

  • Part 1 – Contractor details and authorisation 
  • Part 2 – Submissions
  • Part 3 – Declaration

Part 1 - Contractor details and authorisation   

Please :-

  1. Include the pharmacy stamp in the area provided
  2. Sign and date the WP34C

Part 2 - Submissions

1. The number of forms/items within each group as described below.

  1. Prescriptions where a patient charge has not been paid (including prescriptions dispensed on or after 1st April 2007 with a Welsh Rate Entitlement Card), including resubmitted forms.
  2. Prescriptions where a patient charge has been paid                            

Note: Please insert total figures for all prescriptions submitted, including resubmitted forms. 
(Any unused boxes in the above section only should be left blank i.e. they should not be crossed through in any way)

2. The number of forms/items for  Private Controlled Drug prescriptions is NOT applicable to appliance contractors

3. The number of CD Requisition Forms is NOT applicable to appliance contractors

4. Repeat Authorising forms submitted. (Please indicate by ticking the box – there is no requirement to indicate the number of forms submitted)

Part 3 - Declaration

Areas to complete here include: -

  • The month to which the prescriptions relate
  • The account number
  • The number of hours worked by dispensing staff is NOT applicable to appliance contractors.

Once completed, please fold the WP34C into quarters along the fold lines marked on the document itself, so that the prescriber name/address are visible at the top. This should then be placed at the top of the forms being submitted to Prescribing Services.

Please note that we no longer send out copies of the WP34C each month but you can download one from this site. If you have any issues downloading the WP34C please contact the Helpdesk on 02920 904030 or email



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WP34C Form