Repeat Prescription Requests

If you are not registered for online services, you can use this form to request any repeat prescriptions from the Practice.

There are different kinds of prescription for you to order.

Repeat: These medications do NOT need a review and can be ordered as needed.

Acute: These medication can be requested but are subject to doctor's discretion. These type of medications are ONE OFF and often require review by having an appointment with the doctor

Something New: These are medications you have not had before. You may request these but are subject to the doctor's discretion.

PLEASE BE ADVISED THAT ANY REQUEST IS AT THE DISCRETION OF THE DOCTOR AND CAN BE REJECTED DUE TO CLINICAL DECISIONS

Last Updated: 03/03/2025

Your Details

Name *

Date of Birth *

Phone Number *

Email Address

Medication Required

What medication do you require? *

What type of Medication do you require? *

Acute (One Off)

Repeat

Something New

Additional Comments

Collection Details *

I have left a self-addressed envelope at reception and would like my prescription posted to me.

I have nominated a pharmacy and will arrange my collection from the pharmacy.

I wish to collect from the Practice

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data. *

I consent to the practice collecting and storing my data from this form.

Thank you for your order. Please allow for 3 working days to process the request

Why 3 Working days?

Allowing the practice 3 working days to process prescriptions ensures safe prescribing, all prescription requests need to reviewed by your doctor.

What Next?

If you have checked with your pharmacy after 3 working days and they have not received a prescription please contact the surgery by ringing us.

One of our prescription team members can then follow up the query and liaise with the pharmacy.

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Repeat Prescription Requests

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