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Prescription request form


Please order your medication in good time. If you order both types of medication,
repeat medications may arrive at the pharmacy first.

Allow up to 5 working days for us to process and have the GP sign your prescription.
If you collect your medication from a pharmacy: allow 2 extra days for them to collect and prepare it.
If a repeat prescription needs re-authorising by the GP (check your prescription slip to see how many issues you have left) then allow up to 10 working days.

Allow up to 10 working days for a GP to assess your request.
If you collect your medication from a pharmacy: allow 2 extra days for them to collect and prepare it.
You can only request things you’ve had before.
If you last had an acute medication over a year ago you may need to make a GP review appointment first to discuss your request.

‘Acute /special request medications’ are ones you’ve had before but which haven’t been added to your repeat prescription, generally because their use needs to be closely monitored by a doctor. Examples include many anti-depressants, medicines that can be addictive, or medicines subject to legal or clinical restrictions.

Hospital medication requests

When you’re discharged from hospital, you should normally receive five days supply of medication. If the hospital asks you to hand in any letters or medication requests to us, please upload them at the link below. Hospital requests for change of medication will be checked by the GP first, and if needed we’ll arrange a prescription for you to collect from us or your preferred pharmacy.

HRT & contraceptive pill or patch requests

Please use our HRT review form if you’ve already been prescribed HRT and want to continue with it and request it again, rather than using this form. Please don’t request contraceptive pills or patches via this form – go to our online pill or patch review form to see if you’re able to request it online.

Prescription request form

Repeat Prescription Request
Please use format day/month/year e.g. 12/05/1979

Prescription requests

  • Please copy details of the medication you’re requesting exactly, from your prescription slip.
  • We can only prescribe items on your repeat prescription and some acute / special request medications which you’ve had before recently.
  • If we’ve told you that you need a medication review, we may not be able to complete your prescription request until you’ve had the review appointment.
  • Please check your prescription slip to see how many issues you have left of the medication you’ve requested. If zero, your repeat prescription will need re-authorising by a GP – this takes up to 10 working days and additional time if you collect from a pharmacy.
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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.