Click to change text size
On-line repeat prescription request
Enter your search below


Terms and Conditions
On-Line requests received by 10:15 am will be processed the same day

Repeat prescriptions are usually ready for collection at the Surgery from 1:00pm.

Completed repeat prescriptions are available for collection from the chemist 2 working days later with the exception of one-off and short term use prescriptions.

Patients should complete a consent form at the appropriate pharmacy before they can obtain their medication at their chosen destination. If they have not made these arrangements they will be able to collect prescriptions from the surgery Monday to Friday 8.45am until 6.15pm (the doors shut at 6.30pm).
 
Disclaimer
PLEASE READ
To use this system, you will have to enter information about yourself that will be sent to us across the internet.

This e-form information is not encrypted, but will be no less secure than a normal e-mail.

We cannot guarantee that this information will not be seen by others.
 
Your personal details
Your Doctor
Patient Number (if known)
Full name
Address
Post Code
Date of Birth
 
Other contact details
E-mail Address
Home telephone no.
Other / Mobile

 

 
Prescription requests
Item 1 Strength Qty
Item 2 Strength Qty
Item 3 Strength Qty
Item 4 Strength Qty
Item 5 Strength Qty
Item 6 Strength Qty
Item 7 Strength Qty
Item 8 Strength Qty
 
Additional information

 

 
Collection:
I will collect from:
 
Acceptance
Please confirm your acceptance of Vine Surgery's terms & conditions and disclaimer for on-line repeat prescription requests by inserting your name in the box below.

Accepted by

     

     

We recommend you print off and keep a copy of the repeat prescription order (which pops up after the submit button is pressed).

 

 

 

 

 

 

 

Click for top of page

 

 

 

 

 

 

 

 

 

Click for top of page

 

 

 

 

 

 

 

 

 

Click for top of page

 

 

 

 

 

 

 

 

 

Click for top of page

 
Click for top of page
 
Decrease text size Increase text size Restore original text size