Order a prescription

If you are a patient of the practice and need a repeat prescription please fill the form completely and send the request. Please allow 72 hours to complete your prescription request. We will email it your preferred pharmacy so there is no need to collect it in the surgery.

Sometimes it may not be possible to issue the quantity of medication requested as you may be due a review with the doctor or nurse. In this situation the doctor will issue up to one month prescription and send you a text to book an appointment prior to your next prescription

Please note private 6 month prescription fee is €25, 3 month private prescription fee is €15. If applicable one of your staff will be in contact with you to arrange payment.

Name

First Last

Date of Birth

Email Address

Phone Number

Usual Doctor

Preferred Pharmacy(Required)

Medication required:

Medication

Dose

Quantity