St Paul's Medical Centre

Repeat Prescriptions

Welcome to the St. Paul's Medical Centre, Repeat Prescription Re-order form

Warning: This form sends the information via Internet e-mail to St. Paul's Medical Centre. Internet e-mail is not secure and if you are unhappy about sending the information in the following form over unsecure e-mail then please do not use this service.

Form

Please complete the following form and click submit your repeat prescription request to St. Paul's Medical Centre.

Your Surname

Your Email- to receive a copy of your submitted repeat prescription

Date of Birth

Daytime Contact Number

Pharmacy to be collected from

Drug Name

Qty

Strength

Dosage

Your request will take 2 working days to process.

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