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Repeat Prescription Order Form

If you have any problems with this process, please email prescriptions@gp-k84016.nhs.uk or ring us 01865 240501
* signifies mandatory field

Forename: *
Surname: *
Date of Birth (dd/mm/yyyy): *
Email Address:
if you provide us with an email address we will send you a confirmation email
Drug 1:
Name:
Dose:
Drug 2:
Name:
Dose:
Drug 3:
Name:
Dose:
Drug 4:
Name:
Dose:
Drug 5:
Name:
Dose:
Drug 6:
Name:
Dose:
Drug 7:
Name:
Dose:
Drug 8:
Name:
Dose:
Drug 9:
Name:
Dose:
Drug 10:
Name:
Dose:
Please select where you wish to pick up your presciption The Practice
  Your prescription will be ready for collection at the practice the next working day after 3pm
 
 

Or, you can have your prescription delivered to one of six pharmacies
Please choose one of the following:
  Woodstock Road Chemist (59 Woodstock Rd)
  Boswells (31 Cornmarket St)
  Boots (8 Cornmarket St)
  Woodlands Pharmacy (74 Botley Rd)
  Lloyds Pharmacy (116 Walton Street)
 

Please allow 2 working days for your prescription to be ready for collection at the chemist.

For same day collection, please order your prescription by 10:30 am.