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 REPEAT PRESCRIPTION REQUEST Minimize
 
IN ORDER TO AVOID DELAYS, PLEASE COMPLETE ALL DETAILS.  PLEASE NOTE WE REQUIRE
36 HOURS (1.5 WORKING DAYS) TO PROCESS YOUR PRESCRIPTION.  (WE REQUIRE MORE TIME IF YOUR PRESCRIPTION NEEDS RE-AUTHORISING BY A GP, OR QUERIES ARISE.)

 Press Submit When Complete

Please telephone the surgery after 10.30hrs to enquire whether your prescription is available for collection. 
If you requested your prescription to go to a Pharmacy, please telephone the Pharmacy. 

Most pharmacies offer a collection and/or delivery service.  Please ask at your preferred pharmacy for details.
Patient Name
Patient Postcode
Patient Email
Patient Date of Birth
Medication Name / Dosage
Usual GP
Collection Point
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