Repeat Prescriptions

Please fill in the details below. If received before 10am Monday to Friday your prescription will be ready for collection after 5pm the next day. If we are unable to issue it we will contact you within 1 working day. If you are concerned with confidentiality on the web enter your NHS Number is the spaces below in your personal details. Confidentiality is ensured once received within NHS Net.

Your Details

First Name

Last Name

House No/Name

Street

Email

Telephone

Prescription Details

Please list the drugs or appliances needed clearly below, with any messages.

Which Surgery would you like to pick up your prescription from? Borrowash Chaddesden University