Acute Prescription Request

An Acute Prescription is medication that you have received before and would like to request again without having to make an appointment even though it's not been authorised as repeat prescription. If you wish to request a repeat prescription please register for our Repeat request system.

To make your request, fill in the form below. See under the form for terms and conditions.

Enter your details below:

First Name

* Required




* Required




* Required



Email (Complete if you want to receive a receipt)






Enter your requested items below:

eg Tabs
eg Paracetamol
eg 500mg

How you take it
eg 2 four hourly

eg 56






Message - you must enter a reason for each requested item below:






Enter the code into the Verify box to send:



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Terms and conditions:

We need 2 working days notice to process your request. If you need your medication more urgently than that, please contact our receptionists rather than using this on-line utility.

We need you to provide a reason for your request because you are requesting medication that has not alteady been authorised as a Repeat Prescription. The reason you give will be recorded in your medical records and presented to your doctor for a decision about whether to prescribe. It's OK to keep your reasoning short, simple and to the point. However, If your given reason does not explain why you need the medication, your doctor will not be able to deal with your request.

You may request four items per form submitted.

If you wish to receive an email copy of your request for your records, fill in your email address before you submit your request.

If you make a mistake, don't worry. Just send the information again and explain your error in the comments section.

Occasionally, at the doctor’s instruction, you may be asked to make an appointment for review of your medical condition. This will be discussed with you when you come in to pick up your prescription.

Please do not use our prescription request form for any other communications. Prescription requests are treated differently at our end to other e-mails and your message may get lost in our system.

We use a secure https server for managing prescription requests. If you use this e-mail prescription request facility we guarantee your submission will be secure and confidential and we will not use yor email details for any other purpose that handling your request.