Repeat Prescription Request

Order a Prescription

Use the form below to request your repeat prescription online.

Please Note: You must be registered with our practice before submitting a request.

Important Information Before You Begin

  • Privacy and Security: To protect your personal data, this form does not store your details or medication requests
  • Confirmations: You will not receive an email confirmation. Once submitted, a success message will appear on your screen
  • Email Accuracy: Please double-check your email address before submitting. An incorrect email address will prevent us from processing your request

Prescription Request

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

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.

Please Note: Special requests may not be authorised by the Doctor.
Please arrange this with your pharmacy

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.
Please note: For reasons of privacy this form will not store your details or medication request. There is no email acknowledgement with this service. Once you send this form a notification message will appear to indicate successful submission.