Repeat Prescriptions Slip Sample

When you order a repeat prescription order online, we need to know the name(s) or description of the drugs you require, their quantities and their strength. You can find this information by checking the paper form you received with your original prescription form as shown in the example below. If you do not have an original form to use for your repeat prescription then please contact the surgery for advice.(click on the form below to display a copy on its own page)