Old Oak Surgery

How Do I...
Request Repeat Prescriptions?

Repeat prescriptions will only be issued at the doctor's discretion. We are unable to take repeat prescriptions over the phone; all requests must be in writing either by:

  • Fax
  • Post
  • Email
  • Or submitted in person at the reception

Allow two full working days for collecting prescriptions.
A self-addressed envelope will be required if you need your prescription to be posted back to you.
(You will need to attend for a medication review every 6-12 months.)

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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