Repeat Prescription Request

You can request repeat prescriptions via Patient access if you have regsitered or via the form below if you have not registered yet.

Repeat Prescription Request
Would you like a copy of this request sending by email? *
Is this prescription request: *
Select your preferred pharmacy (We will send your prescripition electronically to the pharmacy you select) *
How would you like to request your prescription? *

Prescription Request (Item by item)

Please provide the details for each item and add a new row for each item you are requesting.

Prescription Request (Scan/Photo of original request form)

Please tick the items you require on your original prescription request form and then upload a scanned copy of this or photograph of your form. Please make sure your scans/photos inlcude all items required and they are easy to read.

Maximum file size: 52.43MB