Prescriptions.

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Prescription request for medications on repeat prescription Allow a minimum of 2 working days before collection. If you are making your request outwith surgery hours, please note that this will not be received until the next working day.

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Name: *

Date of Birth: *

E-mail address: *

Telephone/fax: *

Medication requested *

Pick up point *

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CONFIDENTIALITY

The internet is not secure, and the transmission of data to request

medication is entirely at the patients own risk . The practice accepts no

responsibility for breaches in confidentiality resulting from patients transmissions.

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