REPEAT PRESCRIPTION FORM (VAILID MEDICAL CARD HOLDER)

(Choose One)
Enter a valid medical card number

NOMINATED PHARMACY

Please Note: Once the prescription is complete, the script will be securely emailed to your chosen local pharmacy. You will no longer have to call to the surgery to collect your prescription. Prescriptions are taking 3 working days at present to complete. Please contact your chosen pharmacy regarding collection of medications directly.

MEDICATION

ATTACH PRESCRIPTIONS

If the medications you are requesting have been prescribed by a hospital, consultant etc, please upload a clear image of the prescription. If you are having problems uploading the image, you can drop a copy of the prescription into our Patient Drop-Box at the surgery door so we can add it to you patient chart.
Click or drag a file to this area to upload.