Westway Surgery

029 2059 2351

Repeat prescription form

Prescriptions will be ready to collect after 3pm in 2 working days. Remember the details you submit will be sent to us by unencrypted email via the Internet. This means that complete confidentiality is not possible because we cannot guarantee the security of the Internet. If you are not comfortable with this arrangement you may prefer to order your prescription in person or by post.

Please ensure you complete ALL of the sections marked with an * otherwise the form cannot be sent.

Terms & Conditions

You can request a repeat prescription by completing and submitting an online form. By completing this form you agree to read and accept our terms and conditions

  1. The service is provided only to request repeat prescriptions. It is not to be used to request advice or assistance on any other matter.
  2. You can only order items listed on the repeat request form attached to your last prescription.
  3. If the date for your next review with a doctor or nurse has passed you will be asked to make an appointment.
  4. Prescriptions will be ready to collect after 3pm in 2 working days.
  5. Absolute confidentiality is not possible because we cannot guarantee the security of the Internet. If you are not comfortable with this arrangement you may prefer to order your prescription in person or by post.
  6. An email confirming your repeat request will be sent to the address you provide on the form on the following page.
  7. The practice cannot be held responsible for any delay in receiving your request, nor any technical failure of the system. Please make sure you order repeat prescriptions in plenty of time.