Repeat Prescription form

Repeat Prescription Policy 
If your doctor has prescribed medication for you and has
recommended you to have it on repeat prescription then use the
form below to request it. Please allow 48 hours for the
prescription to be printed and signed

There are some types of medication which we will not issue
without you seeing a doctor or nurse. These include tablets for
high blood pressure, the contraceptive pill and HRT.

Title

Surname
First Name/s
Date of birth
Address
Postcode
Telephone number
E-mail address
Drug name ?
Dose or size of tablet/capsule
(how many mg or mcg)
Quantity: number of tablets or mls/litres etc.

Should you require more than one repeat presciption, please detail below the name, doseage and quantity of the additional items you require, one item per line. 

Once you have sent your request we will process it within 2
working days.You can then pick it up from the surgery. If you
would like prescriptions sent to you then please write in to 
us and enclose a stamped addressed envelope.

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