Repeat Prescriptions | Malahide Road

Repeat Prescription Request

Prescriptions are typically issued during an in person consultation and a plan is put in place for repeat prescription requests. If it has been more than 6 months since you have consulted your doctor or you are taking medications that require blood-test monitoring and/or a blood pressure check, we may advise you by text or email that a consultation is necessary before your repeat prescription can be issued safely.

Please allow 48 hours for the prescription to be sent to your pharmacy.

First Name

Last Name

Date of Birth (dd/mm/yyyy)

Phone

Full Address

Medications (include name of medication, dose, duration)

Usual GP

Nominated Pharmacy

I consent to my prescription being sent digitally sent from the practice to my chosen pharmacy.

I acknowledge that it takes up to 48 hours (excluding weekends) to process repeat prescription requests.

I consent to this message being sent electronically to the practice. I have checked that the email address and phone number supplied are correct and consent to receiving medical information via email or text.

I am a private patient:

Yes

If it greater than six months since your last review, it may be necessary to present for a GP review prior to the issue of a new script

By submitting this form you will be sending personal/sensitive information about yourself across the Internet. Please read our privacy statement to discover how we protect and manage your submitted data. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method of contacting the practice.

Repeat Prescription Request

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