East Parade Medical Practice

How Do I....
Obtain A Repeat Prescription?

In order to obtain repeat prescriptions, please tick the boxes on the right hand side of the prescription and

• post your request(s) in the mailbox in the hall
• hand in your request(s) personally
• post your request(s) enclosing an SAE for its return to you.

If you do not have the right hand side of your prescriptions then please complete the form in reception.

Alternatively, you can phone your request(s) in after 11.00am

Wherever possible, please give 48 hours' notice for your prescription request. If you experience problems collecting your prescription or medication, please inform the reception staff.

THIS FORM BELOW IS CURRENTLY DISABLED - PLEASE USE ONE OF THE ALTERNATIVE METHODS MENTIONED ABOVE TO REQUEST PRESCRIPTIONS.

REPEAT PRESCRIPTION REQUEST FORM
* = Required field
First Names:
*
Last Name:
*
Date of Birth
(dd/mm/yyyy):
*
Email Address:
*
Phone Number:
 
Your Usual Doctor:
Please tell us the drugs you require. Be specific and check your spelling. Please take all details from your repeat prescription record slip.
Drug Name
Strength
*
If you require more than 10 items, please submit another request.
Collection Point :
*
Comments:
(any comments that you may have about this service, or additional medication)

CONFIDENTIALITY - TERMS AND CONDITIONS:
The internet is not secure, and the transmission of data to request medication is entirely at the patient's own risk. The practice accepts no responsibility for breaches in confidentiality resulting from patients' transmissions.

I accept the terms and conditions above*

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