Repeat Prescriptions

 

You can order your repeat prescriptions here and they will be available to collect from the surgery in Emsworth or Westbourne in 2 working days. If you have set up an arrangement with one of the pharmacies listed below to collect on your behalf please select the relevant pharmacy and allow a further working day. Should you wish to change your arrangement at any stage, please inform both the pharmacy and the surgery.

Please print the confirmation page that appears after you submit the form, and bring it with you as this is your receipt.

 

Name:    
Date of Birth:
Telephone Number:

Prescription to be collected from (please select one from the following)  If you make a mistake, press the  "Reset" button below.

Lloyds Pharmacy Emsworth 

Westbourne Pharmacy         

The Old Pharmacy(Preddy's)

Boots West St Havant          

Boots Solent Road Havant   

Davies West St Havant        

Westbourne SURGERY       

If a pharmacy or Westbourne Surgery has not been selected then the prescription will be available at Emsworth surgery.

Your required prescriptions :

(Please enter drug, dose and amount - i.e. Paracetamol, 500mg, 40.)

1.
2.
3.
4.
5.

 

 

If you need more than five items simply resubmit this form.

 

 

 

 

 

Although we will never pass the information given on this form to a third party we cannot guarantee the information submitted is completely secure.