Repeat Prescription Request Form

Please complete the below for any repeat prescription request. In completing this form you are consenting to supplementary prescribing to allow any of our prescribing team to issue repeat prescriptions to prevent delay. 

Prescription charges cover the administration of the repeat request and the time taken by the prescribing clinician to cross check the clinical file for correct medication, dosage, and then to write the prescription. 

Please note that 7-10 days’ notice will be required for repeat prescriptions and that your pharmacist will charge for the medication itself in addition. 

If you nominate someone to collect a prescription from us on your behalf we may contact you to check. The person collecting will be asked to confirm details (name, address, DOB ) of the person for whom the medication is prescribed. 

If you have any problems using this online prescription request form please telephone the office on 01392 829989. 

We cannot guarantee that your pharmacist will accept an e-mailed white prescription, they may request a signed copy that will need posting to you.