Repeat Prescription Request Form

Please complete the below for any repeat prescription request. In completing this form you are consenting to supplementary prescribing to allow any of our prescribing team to issue repeat prescriptions to prevent delay. 

Prescription charges cover the administration of the repeat request and the time taken by the prescribing clinician to cross check the clinical file for correct medication, dosage, and then to write the prescription. 

Please note that 7-10 days’ notice will be required for repeat prescriptions and that your pharmacist will charge for the medication itself in addition. 

If you nominate someone to collect a prescription from us on your behalf we may contact you to check. The person collecting will be asked to confirm details (name, address, DOB ) of the person for whom the medication is prescribed. 

If you have any problems using this online prescription request form please telephone the office on 01392 829989. 

We cannot guarantee that your pharmacist will accept an e-mailed white prescription, they may request a signed copy that will need posting to you.

 

Repeat Prescriptions
Address
Address
City
County
Post Code
Country
Preferred method of contact
Charges (please select)
Delivery Method (please select)
Please note: Once a prescription has been collected by Royal Mail, EPIC Solutions is no longer responsible for the item and cannot be held liable for delivery delays or delivery failures. Tracking numbers are available on request for all posted orders. **Although Royal Mail offers a “Guaranteed by 1pm Special Delivery” service, delivery by this time cannot be guaranteed by EPIC Solutions. Actual delivery times depend on prescription ordering, processing, and collection by Royal Mail. To use the Signed For & Tracked Special Delivery by 1pm service, orders must be received by the prescribing team by 2pm on the working day prior to the intended delivery date. Please also note that due to our closing times on Fridays, we do not offer the Signed For & Tracked Special Delivery by 1pm option.