Please note that we do NOT accept Repeat Prescription requests by email, any received will be ignored. This online form is the ONLY accepted method for receiving online Repeat Presciptions. All the information you need to complete this online form can be found on the paper Repeat Prescription form issued to you by your Doctor. It is important that we receive a fully completed online form containing the correct data otherwise a Repeat Prescription cannot be issued. We can only accept Repeat Prescription requests for items listed on your paper Repeat Prescription form, unauthorised items cannot be dispensed.      If you want information about your prescription, Click Help for a new window to open with information. If you would like this form to retain previously entered information you will need to ensure that your browser preferences are set to enable the use of cookies and javascript.
NOTE: Please add NoReply@ParkwayMedicalCentre.com to your anti-spam lists otherwise you may not receive the confirmation message. Some providers block emails that are repeated. If you order the same prescription each month and sometimes not get a confirmation, it may be because your email provider has seen a similar email sent multiple times and blocked it. Please ensure your spam settings allow the address: NoReply@ParkwayMedicalCentre.com
Patient Name:
Address:
Date Of Birth:	(DD/MM/YYYY)
Telephone:
Email Address:
	Item Description	Dose	Strength
Example Item
Item 1:
Item 2:
Item 3:
Item 4:
Item 5:
Item 6:
Item 7:
Item 8:
Item 9:
Additional Information:
A 'confirmation of receipt' email will be sent to you so that you know your Repeat Prescription request has been sent to us. Please allow two working days for your prescription to be prepared from the date of the confirmation email. Collect your prescription from your usual delivery location.