How to Use This Form

Ensure that you complete all steps of this form to successfully request your prescription order online.

Please note that this facility is ONLY for ordering repeat prescription items, which are listed on the right-hand side of your printed prescription form. You should contact the surgery for any requests for other prescriptions.

You will also receive a notification email to your inbox confirming that the order has been sent successfully. If you do not receive a confirmation, please check your Junk or Spam email folders before contacting the Practice.


Our prescription order form is encrypted and secured by a 128bit SSL certificate, and sends your request information in the content of an email. Although this is sent ONLY to the Practice, we are unable to guarantee complete privacy during the transmission.

If you have any concerns with regards to using this service, please speak to the Practice about other methods of ordering your prescription.

What is GDPR?

The EU General Data Protection Regulation (GDPR) is the most important change in data privacy regulation in 20 years. GDPR fundamentally reshapes the way in which data is handled across every sector, from healthcare to banking and beyond.

As part of our data privacy obligations, we have to ensure that when we collect information about you that we are fully compliant with GDPR. For more information, please see the Guide to the General Data Protection Regulation (GDPR) article on the ICO website .