Prescriptions

Before ordering online please read the below

Repeat prescription requests: up to 5 working days
Acute medications / special request medications: up to 10 working days
It may take additional time for your pharmacy to process the prescription
Make sure you allow enough time to order your medication

You can’t order medication you’ve never had before via our online form
Please call us to book an appointment to discuss this.

Please check your prescription slip when you collect your medication
It may have an important note from the doctor on it – for example to let you know you need to book a
review, before your medication can be issued again. Please don’t wait until your medication is due to run out.

This form is for repeat prescription and acute medication / special request medications only. You can read more about these and expected timelines here – they may not be sent to the pharmacy at the same time. For the contraceptive pill, please call us to book an appointment with one of our Practice nurses.

Once you click submit, your prescription request will be sent to us. You won’t receive an email confirmation. Please check the timelines above before calling us about your medication.

Repeat Prescription Request

First Name

Last Name

Enter Email

Confirm Email

Date of birth

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

Phone Number

Prescription Items

Copy exactly the details from a prescription slip you have received from the practice.

Please note that items will only be dispensed if they are included in a prescription from the practice and a medication review is not pending.

Item 1

Item 2

Item 3

Item 4

Item 5

Item 6

Item 7

Item 8

Item 9

Item 10

Item 11

Item 12

Item 13

Item 14

Item 15

Special Medication Request

Please Note: Special requests may not be authorised by the Doctor.

Collect from

Privacy Policy

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.

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Before ordering online please read the below

Prescription Items

Privacy Policy

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