Existing Customers

Repeat Prescription Service

* Indicates required field

Name *

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Last

If you regularly take the same medicines our Repeat Prescription service can make your life a lot easier.

It’s quick and easy to set up and totally free - here are some of the key features and benefits:

We can save you and your surgery time and trouble
You won’t need to visit the surgery to collect your prescription because we will collect it for you
There is no need to wait in the pharmacy to collect your prescription because it will be ready and waiting for you
We can hold your repeat slip in the pharmacy and order your prescription at your request

Simply download and complete the Repeat Prescription sign up form and drop it in next time you are passing or alternatively call in and pick up a leaflet .
We can also help you fill it in – all you have to do is ask.

NHS number (if known) *

Address *

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Telephone *

Email *

Have you ordered your prescription? *

Can you please order my prescription No, I have ordered my prescription and will be ready within 72 hours Please call me, I am unsure

Comment *

Collection or Delivery? *

Please deliver my prescription No thank you, I will collect

Consent *

I am the patient named above/carer of the patient named above. Nomination has been explained to me and I have also been offered a leaflet that explains nomination. I would like to nominate Hirshmans Chemists as my nominated pharmacy for dispensing prescriptions issued by the NHS Electronic Prescription Service.

Submit My Prescription