How Do I....Obtain A Repeat Prescription?

Patients who require repeat prescriptions should give 24 hours' notice either by phone or by filling in a repeat prescription form which is available at reception.



THIS FORM BELOW IS CURRENTLY DISABLED - PLEASE USE ONE OF THE ALTERNATIVE METHODS MENTIONED ABOVE TO REQUEST PRESCRIPTIONS.

First Names:
Last Name:
Date of Birth: (dd/mm/yyyy)
Address:
Phone Number:
Email Address:
Surgery:
Please tell us what medication you require. Be specific and check your spelling. Please take all details from your repeat prescription record slip.
Drug Name Strength

If you require more than 8 items, please submit another request.
Comments (any comments that you may have about this service)

CONFIDENTIALITY - TERMS AND CONDITIONS
The internet is not secure, and the transmission of data to request medication is entirely at the patient's own risk. The Pharmacy accepts no responsibility for breaches in confidentiality resulting from patients' transmissions.

I accept the terms and conditions above and understand that by ticking this box I give my consent for ***************** to order, pick up and dispense this repeat prescription.
 
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