Prescription Request | Adelaide Street Family Practice

From 7^th October 2019 a pharmacy will not be able to order repeat prescriptions on your behalf. You or your carer must order the medicines you need using any of the following methods:

MyGP app – if you have a smart phone or iPad (download from your usual app store)
Patient Access – secure online service (visit https://app.patientaccess.com/registration/create)
Email to [email protected] our dedicated prescription email address
Drop off or post the re-order slip, selecting only the items you need. If you don’t have your slip from your last prescription, you can use one of our request forms or simply write a list
Fill in and submit the form below.

First Name *

Surname *

Date of Birth (dd/mm/yyyy) *

Contact Phone Number *

Address

Town

Post Code *

Items:

Item 1

Strength

Item 2

Strength

Item 3

Strength

Item 4

Strength

Item 5

Strength

Item 6

Strength

Item 7

Strength

Item 8

Strength

Item 9

Strength

Item 10

Strength

Comments

PLEASE NOTE: Your prescription will go to the same place as your previous prescription, unless you sepcifically notify us to the contrary. This now also applies to 'special requests'.

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