Prescription Ordering

Order a short term medication

A short term medication (acute medication) is one that is prescribed for short term use only and will not appear on your regular list of medicines online or on the back of your green prescription. They should not routinely be ordered without a telephone/clinic consultation with a healthcare professional.

However, it is recognised that a medicine may be needed for longer than initially supplied. This order form should be used to order such medicines and a reason for the request MUST be given.

Our staff will not be able to process the request unless a reason is documented and may still require you to book an appointment before a prescription is written.

You can complete the online form here below or complete a form by coming into the practice.

Requests take 48 hours to process, please note you must give enough information on the form for the request to be processed, any missing information will result in a delay.

This form is used to order medication that you may not get on a regular basis.
Name*
First Last
Date of Birth*
Telephone*

If there are any problems with issuing your prescription, we may call you to let you know.
Medications required*
Drug/Medication Dose Quantity/Size
Reason for ordering*
Privacy*
- By using this form you agree with the storage and handling of your data by this website.
Name
This field is for validation purposes and should be left unchanged.