Repeat Prescription Request

Please use this form to order your repeat prescription. Once you have submitted your request you will receive an email confirmation that your request has been successfully submitted. Please allow 48 hours, excluding weekends and Bank Holidays, for your request to be processed. Any problems please telephone the surgery. Please note we will email you if we cannot issue your request. If you are requesting an item urgently please contact the surgery and we will be happy to confirm if it is ready for collection.

Sometimes we may not be able to issue certain medications on a repeat prescription request.

 

Repeat Prescription Request

About You

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.

Medication Required

Item Description
Strength
Quantity

Additional Medication Required

Item Description
Strength
Quantity