Belvedere Medical Centre
doctor and child

HOW DO I....
Obtain A Repeat Prescription?

For patients who are on continuous drug treatments, we can issue repeat prescriptions without the patient needing to visit the doctor every time. Please use your repeat prescription slip, indicating the items you require. If you have lost the computer slip, write your name and address, together with the details of your prescription (copied from the bottle or tube) clearly on a piece of paper and hand it in at the reception desk or send it to us by post. If you would like your prescription posted back to you please supply a stamped addressed envelope. Always allow 48 hours (two working days) to complete your request. Repeat prescription requests cannot be accepted by phone.

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

REPEAT PRESCRIPTION REQUEST FORM
* = Required field
First Names:
*
Last Name:
*
Date of Birth
(dd/mm/yyyy):
*
Email Address:
*
Phone Number:
 
Your Usual Doctor:
Please tell us the drugs 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 10 items, please submit another request.
Collection Point :
*
Comments:
(any comments that you may have about this service, or additional medication)

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 practice accepts no responsibility for breaches in confidentiality resulting from patients' transmissions.

I accept the terms and conditions above*

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