Repeat Prescription Order Form

Please fill out the form below to place your order

We CANNOT take orders for prescriptions over the phone, all requests must be submitted on this order form.  
We ONLY accept Standard Repeat Prescription Orders for Registered Patients of the Practice Only 
Hospital Scripts (attachments) or follow up queries can be emailed to [email protected]  

NB: 72 hour turn around time, please ensure to place your order a minimum of 5 days in advance of script due.

Please note the Long-Term Illness Scheme covers patients for free drugs, medicines and medical and surgical appliances for the treatment of that condition.  This card does not cover any GP Services, the standard fee for repeat scripts still applies. 

Repeat Prescription for Monthly Contraceptive Pill – Free Service for 17-35 years   (Non GMS/DVC patients 35yrs+ fee applicable). 
Please complete the following form and Tel: 018339856 to book an Appointment for BP Check.  If Additional services required during this consultation please advise at booking, as additional time maybe required for your appointment and fees applicable.  Please select Patient Type = Well Woman 17-35yrs for relevant prescription orders. 

Please Note

We can only process Repeat Prescription Orders that are submitted with the above form.

Additionaly please Note:

• 72 hour turn around (during working days) for script to be ready
• Medication Review every 6 months, before script can be reissued, please phone 01 8331650 to arrange telephone consultation.
• Please advise of any recent hospital changes to your medications so that we can reconcile with our records (hospital report may not yet be received). If possible please email us a copy of new hospital script to [email protected]
• Please arrange follow up call to the surgery on 01 8331650 to arrange payment for script to be issued to your choice of pharmacy.