Repeat Prescription Form

Repeat Prescription Form

Aged 16 or over?

We are no longer accepting requests via the current online form for patients aged 16 years and over. If you are 16 years or over you can now request your repeat prescription either via the new online service "Patient Access", click HERE for more information, or alternatively you can use the right-hand side of your last prescription by ticking the items you need and dropping the request into the surgery.

Please note that repeat prescriptions cannot be processed over the phone or by email.

Alternatively you can use the right-hand side of your last prescription by ticking the items you need and dropping the request into the surgery. Please note that repeat prescriptions cannot be processed over the phone or by email.

Please allow 3 working days before collecting your prescription.

Please ensure you complete ALL of the sections marked with an * otherwise the form cannot be sent. You can request up to 6 items per form, if you have more than 6 items please complete further form(s).

Your Details

E.g Atenolol
E.g 50mg NB:If required please type "percentage" not the symbol "%".
E.g 25 tabs