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Repeat Prescriptions
 
 
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Richmond Medical Centre
179 Richmond Road
Solihull
West Midlands
B92 7SA
Tel:  0121 743 2159
Fax: 0121 743 7802
 
 

 
 
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If you require a repeat prescription, please request at least 48 hours before you run out - you should have a repeat prescription slip to help you complete the form, if not it would be helpful to have your current medication in front of you. The form is not encrypted and therefore complete confidentiality cannot be guaranteed. Using this form is like sending a fax request.
Your Surname:      
Your First Name:
Your Date of Birth:     
1st Drug

       Amount (e.g. 30)    

2nd Drug

     Amount (e.g. 30)  
3rd Drug

     Amount (e.g. 30)   
4th Drug

     Amount (e.g. 30)    
5th Drug

    Amount (e.g. 30)  
How long do you want the prescription to last: (Weeks)
Any other comment?

    

 
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Information on this website is for registered patients only and should not be used as a substitute for seeking advice from a GP.
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