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Prescription Builder

Using our Glutafin gluten free food request form our Prescription Builder helps you get the most out of your prescription allowance.

Fill in your unit allowance, and the quantity of each product you'd like then press ' Save to your prescription' and this tool will calculate if you are within your allowance.

Then simply print out this form, and hand it to your GP or Pharmacist* to help you start ordering.


I would like the following gluten free products to be added to my monthly allowance as per the revised National Prescribing Guidelines for gluten free foods (2011).




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Quantity
Pip Code
Unit Guide
Lactose Free
Wheat Free
Gluten Free
Glutafin Gluten Free Select Fresh White Loaf (400g) ✝
290-6840
8
Glutafin Gluten Free Select Fresh Brown Loaf (400g) ✝
330-6800
8
Glutafin Gluten Free Select Fresh Seeded Loaf (400g) ✝
402-3685
8
Glutafin Gluten Free Select Seeded Loaf (400g)
308-9364
1
Glutafin Gluten Free Select White Loaf (400g)
054-6093
1
Glutafin Gluten Free Select Fibre Loaf (400g)
054-6101
1
Glutafin Gluten Free Select Multipurpose White Mix (500g)
004-5187
2
Glutafin Gluten Free Select Multipurpose Fibre Mix (500g)
004-5591
2
Glutafin Gluten Free Select Bread Mix (500g)
274-4951
2
Glutafin Gluten Free Select Fibre Bread Mix (500g)
297-9912
2
Quantity
Pip Code
Unit Guide
Lactose Free
Wheat Free
Gluten Free
Glutafin Gluten Free High Fibre Loaf (350g)
401-4296
1
Glutafin Gluten Free White Loaf (300g)
090-4268
1
Glutafin Gluten Free Fibre Loaf (300g)
237-7356
1
Glutafin Gluten Free Part-Baked 4 Fibre Rolls (200g)
344-3652
½
Glutafin Gluten Free Part-Baked 4 White Rolls (200g)
344-2753
½
Glutafin Gluten Free Part-Baked 2 Long White Rolls (150g)
344-3637
½
Glutafin Gluten Free Part-Baked 2 Baguettes (350g)
224-0117
1
Glutafin Gluten Free 4 White Rolls (200g)
344-3645
½
Glutafin Gluten Free Multipurpose White Mix (500g)
231-2981
2
Glutafin Gluten Free Multipurpose Fibre Mix (500g)
231-2973
2
Glutafin Gluten Free Bread Mix (500g)
298-8418
2
Glutafin Gluten Free Fibre Bread Mix (500g)
298-8426
2

Please note, this is a full list of all Glutafin products, availability varies depending on your area's individual prescribing policy. Units have been calculated based on Coeliac UK prescribing guidelines, however, this may also vary by area.

*Take this form to your pharmacist if you are in a Pharmacy Lead Prescribing Scheme area.

✝ Gluten Fresh Bread is supplied in cases of 8 loaves – this uses 8 units of your monthly allowance.

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