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   ■ ■ ■ On-line Repeat Prescriptions  
Before entering your prescription details below you must first read this disclaimer . At present data transferred in this manner is only as secure as a standard e-mail.

If possible information should be copied directly from your repeat form.
  
You can ask for medication that you have previously been prescribed but is not currently on your repeat form.
 
We must be absolutely clear what repeat you require and if there is any confusion at our end we will contact you to clarify the request.
 
First Name:  
Surname:  
Address:  
Post Code:  
Telephone:
E-mail (if appropriate):
Date of birth dd/mm/yyyy:  

For all patients having to collect from Boots, Lloyds or Rowlands please allow 3 full working days. Please allow 2 full working days when collecting from the practice as a minimum; could be 3.

  
Collection:

 
 
  Medicine

  Strength
1
2
3
4
5
6
7
8
9
 
 
Comments: Enter any other requests or comments below

 
 
Click Submit to send your request to Wallingford Medical Practice Repeat prescription system

Coming next is a confirmation form where you can check your request .

Tick this box if it is a corrected request