Increase Font Size

How Do I... Obtain A Repeat Prescrition?

Repeat prescriptions are issued by computer together with a tear-off slip, which is a copy of repeat medication. When requesting a repeat prescription please tick the items required on that copy and post or bring it to the surgery. Please allow 48 hours before collection.
If you wish to have your prescription posted please provide a stamped self-addressed envelope.
Alliance and Trio Pharmacies (both in Shepperton) can pick up and deliver prescriptions and medication if requested.
Unfortunately we cannot accept requests for repeat prescriptions over the telephone as this could cause errors.


THIS FORM BELOW IS CURRENTLY DISABLED - PLEASE USE ONE OF THE ALTERNATIVE METHODS MENTIONED ABOVE TO REQUEST PRESCRIPTIONS.

First Names:
Last Name:
Date of Birth: (dd/mm/yyyy)
Address:
Phone Number:
Email Address:
Surgery:
Please tell us what medication you require. Be specific and check your spelling. Please take all details from your repeat prescription record slip.
Drug Name Strength

If you require more than 8 items, please submit another request.
Comments (any comments that you may have about this service)

CONFIDENTIALITY - TERMS AND CONDITIONS
The internet is not secure, and the transmission of data to request medication is entirely at the patient's own risk. The Pharmacy accepts no responsibility for breaches in confidentiality resulting from patients' transmissions.

I accept the terms and conditions above and understand that by ticking this box I give my consent for ***************** to order, pick up and dispense this repeat prescription.
 
spacer
Your Business Here
spacer
pay monthly websites




spacer

spacer
Upper Halliford Nursing Home
spacer