Repeat Prescription Request

 

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Please complete our online form

  • If the form has been correctly submitted, you will receive a response immediately with a reference number beginning 170
  • If you do not receive a response, please check the form and resubmit until you receive the 170 reference number
  • Our prescribing policy is to allow up to 72 hours (3 working days) for your request to be processed plus dispensing time at the pharmacy
  • Urgent requests are usually processed in 24 hours if we are aware the request is urgent
  • If you still have issues, please telephone the practice on 01295 256 261
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Your Personal Details
Medication Required

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.

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

 
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