Repeat Prescriptions

To order a repeat prescription, please fill in the form below. A prescription will be issued to the pharmacy of your choice. To ensure the quality of your ongoing care, the Doctor may ask you to attend an appointment to review your medication or contact you by telephone.

Repeat Prescription

  • Patient Details

    Please fill out your patient details below before requesting a repeat prescription.

  • DD slash MM slash YYYY
  •  

    Prescription Details

    You may request up to ten separate items, enter the name and the strength of each item on your prescription. Type Yes in the 'Required' column if you need the item this time and No if you do not require the item this time.

    Please note that items will only be dispensed if they are included on your repeat prescription and a medication review is not pending

  • If your pharmacy has more than one branch, please specify, as well as phone or email if you have this information
  • Medication NameQuantity and/or Strength (i.e. 1mg a day) 
  • € 0.00
  • This field is for validation purposes and should be left unchanged.

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