Long Lane Medical Centre

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Please note that we have tried to make this repeat prescription request service as secure as possible but cannot guarantee 100% security. As always on the internet, you should not send any information you would rather others did not see.

In order to make this form even more secure, we can no longer take your name, but instead require your prescriber number and date of birth. This number can also be found on the top right of the white tearoff section of your prescription. Please contact the surgery if you are unsure of your prescriber number. This is simply as a precaution to ensure that prescriptions can only be requested by the individual concerned.

Your prescriber number should remain private. Please do not tell others your individual number.

  
  Use the form below to email the request. We can fax prescriptions to the local chemists for the housebound only. Please allow two working days to turn around your order if this form is used. Please note that this service is only available to registered patients. If you are wishing to request more than 10 items, please complete the form again once the initial 10 items have been requested.

Guide to Obtaining repeat Prescriptions

  1. Antibiotics will not be issued without seeing, or discussion with, a doctor.
  2. Please allow 48 hours for repeat prescriptions to be issued.
  3. Prescriptions can be ordered between the following times:- 10.30am - 12.30pm, 1.30pm - 5.00pm.
  4. Only medication which appears on computer as a repeat medicine can be issued by a receptionist.
  5. You need to know the names of repeat medication when telephoning or visiting the surgery.
  6. Where there is doubt about a request for medication a doctor will need to resolve the problem. This takes extra time.
  7. Repeat prescriptions will be issued for 28 days. All repeat prescriptions are reviewed after 12 months. You may be asked to see a doctor or nurse before your medication is re-authorised.
  8. If medication is changed (e.g.) following hospital admission, we will need to confirm this change and a doctor will need to authorise this on computer. To enable this to be problem-free bring all bottles and packets with you.

Prescriber Number (see info, above left)
Date of Birth
Drug 1
Drug 2
Drug 3
Drug 4
Drug 5
Drug 6
Drug 7
Drug 8
Drug 9
Drug 10

Fax to Chemist
(housebound only)

Send to Landford Pharmacy
(Landford Avenue)
 
         
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