Available On NHS Prescription

If you would like to request your support wear on prescription or you are already using CUI support wear and have previously obtained it on NHS prescription and would like to request another garment within your yearly allowance (2-3 support garments per annum at your GP’s discretion) please complete the prescription request form below and we will contact your GP practice or your nominated delivery company with your request. Please allow up to 4 weeks for delivery for a stock item and 6 weeks for a bespoke item, allowing time for receiving and processing the prescription and delivery of your requested garment. If you need any guidance with completing this form, please contact our Customer Service Team on 0800 279 2050.

Prescription Request Form

Your Details

Product Details

Doctory and Surgery Information

If your garment is not listed or is a bespoke order, please contact us on: 0800 279 2050

*Please note we recommend that a consultation/assessment (remote or face to face) is carried out by one of our experienced Support Specialists for guidance on appropriate garment and fit, prior to requesting a hernia support garment on prescription.

*Ensure that all details have been checked before submitting this form.

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At CUI International Ltd we are committed to protecting and respecting your privacy. The personal information on this form will be used to assist in the preparation of your order. We will only keep your personal data for as long as required for the stated purpose; your details will be stored securely during this time. CUI International Ltd company registration number is 02018517 and our registered address is: CUI International Ltd, Medalin Group, Caldow House, Crescent Road, Lutterworth, LE17 4PE.