Prescriptions

Synchronising Prescriptions form

If you would like to save time and order all the medication you have on repeat at the same time rather than irregular times throughout the month please use the form below.

When you next need to request an item on repeat count up all the tablets you have and fill in the form. Your doctor will issue a “one off” prescription of the tablets you need to synchronise all your medication to within a day or two.

About You

Please include all your given names.
Please use this date format: DD/MM/YYYY.
Please ensure that your email address is correct as this is how you will be notified of a reply.
Please include postcode.

Medication Required:

Item Description
How many tablets do you take each day?
Quantity Left

Please note that the details you give will be used to update your medical records.