Online Prescriptions

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Tel: 01753 541268

Request a Repeat Prescription Online

This service will not be available after 31.12.2010. Please contact the surgery and register for Emis access, our new online prescription request service.

Click here to use the new Emis Access service

Disclaimer:

Please note this is not a secure form.
This form is sent to us via computers that do not belong to the NHS in a non-encrypted format. Complete confidentiality for this type of repeat prescription request can not be guaranteed. If you have an issue with this please feel free to use our normal repeat prescription service.

Please allow 2 working days before collection.

Patients Name*

Date of Birth*

Address

Email Address

Contact Tel.*

Patient No.*(found on your repeat slip)

Your Doctor

Please select where you want to collect your prescription

* You must provide this information.

Item Description

Quantity

(e.g. Paracetamol)

(e.g. 100)

Item 1

Item 2

Item 3

Item 4

Item 5

Item 6

Item 7

Item 8

* Not for medical problems *

Comments about this Prescription

CONTACT US

Urgent Problems/
Home Visits/
Enquiries
01753 541268

Appointments:
01753 546088

Fax number:
01753 582324

Health Visitor:
01753 636519

District Nurse:
01753 636500

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CLICK HERE to order repeat medication online

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