This form is designed to obtain appropriate information from our registered patients who, for various reasons, need to request medication that has not been placed on repeat issue by the GP. This is usually for chronic conditions when you may need a medicine you were issued previously or when a hospital has advised certain medications.
Non-urgent advice: Notice
This form is NOT to ask for prescriptions if you are unwell or need medical treatment, e.g antibiotics. Instead submit an online consultation for non urgent medical advice by Clicking HERE. For urgent medical advice telephone your medical practice or call 111.
These prescription requests will be reviewed by the doctor/Surgery pharmacist to understand the reasons for your request and to avoid clinical errors.
Note – Submitting this request DOES NOT mean your prescription will automatically be issued and you may need to have a review or further discussion with your GP/Surgery Pharmacist.
If you have been seen privately and given a private prescription, this form DOES NOT permit this to be converted to an NHS prescription. Instead you will need to provide details and discuss things further with a GP/Surgery Pharmacist.