This form must only be used to request medication that is currently authorised for re-issue. Please ensure you enter a valid email and telephone number in case we need to contact you. In an emergency please contact us directly.
Please Note: This form is sent to us in a non-encrypted format. Complete confidentiality for this type of repeat prescription request can not be guaranteed. If you have an issue with this please feel free to use our normal repeat prescription service.
Your prescription request will be processed by us within 48 hours. Please allow the Pharmacists a further 24 hours to prepare your medicines safely. Please remember to check your medicine(s) before leaving the chemist premises.
For alternative ways of requesting a repeat prescription, return to the home page select our services, repeat prescription.
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