Repeat Prescriptions

Repeat Prescription Request

You may use this form to request medications that have been prescribed to you on a regular basis in the past.

Important: Do not use this form to submit clinical queries. Clinical queries can only be addressed by appointment.

If it has been more than 6 months since you have seen the doctor, or if you are taking medications that require blood-test monitoring we may ask you to make an appointment before we issue the prescription.

Please allow 48 hours for the prescription to be sent to your pharmacy.

There is a charge for repeat prescriptions unless you hold a valid medical card or doctor visit card.

First Name

Last Name

Date of Birth (dd/mm/yyyy)

Phone

Full Address

Medications (include name of medication, dose, duration)(max 100 characters)

Usual GP

Nominated Pharmacy

I consent to my prescription being sent digitally sent from the practice to my chosen pharmacy.

I acknowledge that it takes up to 48 hours (excluding weekends) to process repeat prescription requests.

I consent to this message being sent electronically to the practice. I have checked that the email address and phone number supplied are correct and consent to receiving medical information via email or text.

I am a:

Medical Card Patient

Private Patient

I acknowledge there is a fee of €20 for private repeat prescriptions & I will pay via the payment link sent by SMS.

By submitting this form you will be sending personal/sensitive information about yourself across the Internet. Please read our privacy statement to discover how we protect and manage your submitted data. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method of contacting the practice.

Repeat Prescription Request

Contact

Opening Hours

Links

For Life Threatening Emergencies - Call 999 or 112