Your personal details

Your address

Your Doctor’s surgery details

Select Area*

Medication required

Please enter your medications exactly as they appear on your surgery re-ordering form.
The items requested MUST be on your regular repeat medication list.

Prescription example

Drug Name & Strength*
Paracetamol 500mg (example)
Directions
Two, four times a day (example)
Quantity
100 (example)

A maximum of 20 items allowed.

Collection/Delivery

Would you like your prescription delivered?*
Preferred Health Plus Pharmacy for collection*

The Free Repeat Prescription Delivery service is available for vulnerable individuals with chronic conditions or disabilities. Eligibility for this free service is determined at the discretion of the pharmacy.

Important information

  • The first attempt of delivering your prescription is free.
  • Failed deliveries will require the patient, to arrange collection from your local Health Plus Pharmacy.
  • If you would like us to re-attempt a 2nd delivery there will be a small charge of £2.

Advised consent

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Thank you for completing the online Repeat Prescription Registration Form

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