New Line Requests

Use this part of the site to request additions to the Northern Lincolnshire Medicine Formulary. Below is an option to complete a new line request using a Word (or other word processor software e.g. Libre Office) document. Alternatively you can access and easy online version of the New Line Request form by clicking the link below. Before completing a New Line Request form, please read, understand and agree to the New Line Request Terms and Conditions.

Click here to DOWNLOAD a blank New Line Request form


Click Here to Access the ONLINE New Line Request Form

The Online New Line Request Form is password protected. Please call the Pharmacy Office at Scunthorpe General Hospital on 01724 290095, or email for a password.

If you would like to complete the form in a word processed document and discuss it with your team/department before submission, the system allows you to download the New Line Request form and edit it on your computer. This form can then be uploaded to this site using the Submit New Line Request link below. Your form is then automatically sent to the APC for dissemination to all the relevant decision making groups. If you prefer, you can call Aliya Turk on 01724 290095 and have the form completed over the telephone. Otherwise send an email requesting a call at a time convenient for you.

Click here to DOWNLOAD a blank New Line Request form

Click here to SUBMIT a New Line Request form