Request repeat prescription

Repeat prescriptions can be ordered by phone by choosing the option for our 'recipe line', getting in contact with our assistant or by using this repeat prescription form.

To be able to use this form you must be registered at our practice and the medication you order must already been prescripted to you by your general practicioner or other medical specialist.

After submitting the form you will receive a confirmation email at the address given in the form.
When we have received your request before 12:00 and without further notice from us, your prescription will be available after two working days after 16:00 at the pharmacy you selected.

Repeat prescription form

Repeat medication
Your data (1)
Your data (2)
Confirmation

Fill in the information concerning the repeat medication.

Medication

	Name	Potency	Amount	Dosage	Weight
	Name	Potency	Amount	Dosage	Item weight

more items

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Use x to remove a row.

Pharmacy