Repeat Prescription Request

If you do not have a Patient Online Services account, you can use this form to request your repeat medication if you have nominated a pharmacy to process your prescriptions. If you haven’t done this please register for Electronic Prescribing before submitting your request form.

Please allow three working days before collecting your prescription.

In future you may wish to consider registering for our Patient Online Services which enables you to manage your medication, book and cancel routine doctors’ appointments and access your medical records.

Repeat Prescription Request

About You

Please use this date format: DD/MM/YYYY.

Controlled Drugs

Medication Required

Item Description
Strength
Quantity

Your Prescription will be ready for collection from your chosen pharmacy after 12.00pm on Thursday.

Your Prescription will be ready for collection from your chosen pharmacy after 12.00pm on Friday.

Your Prescription will be ready for collection from your chosen pharmacy after 12.00pm on Monday.

Your Prescription will be ready for collection from your chosen pharmacy after 12.00pm on Tuesday.

Your Prescription will be ready for collection from your chosen pharmacy after 12.00pm on Wednesday.

Your Prescription will be ready for collection from your chosen pharmacy after 12.00pm on Wednesday.

Your Prescription will be ready for collection from your chosen pharmacy after 12.00pm on Wednesday.

Your Prescription will be ready for collection from your chosen pharmacy after 12.00pm on Thursday.

Your Prescription will be ready for collection from your chosen pharmacy after 12.00pm on Friday.

Your Prescription will be ready for collection from your chosen pharmacy after 12.00pm on Monday.

Your Prescription will be ready for collection from your chosen pharmacy after 4.00pm on Tuesday.