Summerlands Surgery Repeat Prescription Requests

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Online Repeat Prescription Request

Are you a regular user of this service?
If so click here to download a reusable email form.
Once completed, you can email it each time you need to request your medication.
Alternatively, complete the single use form below.

First Name

Last Name

Date of Birth

Postcode

Email

Any queries regarding your request will be emailed to you, so please check it regularly to avoid delays.

Prescriptions can be collected from the surgery or sent directly to a pharmacy. Please choose from the list.

Collect from surgery

Sainsbury's

Village Pharmacy (Farnborough)

Steven's

Village Pharmacy (Crofton)

Rowland's

Boots (Orpington)

Drug Name

Strength e.g. 10mg

Frequency e.g. 2 tabs twice daily

Amount e.g. 84 tabs or 500 mls

2 months supply is standard issue for most drugs (6 months for contraceptive pills).

Condition to treat if not on regular repeat medication list

Additional Information

Or scroll down to add more.

Drug Name

Strength e.g. 10mg

Frequency e.g. 2 tabs twice daily

Amount e.g. 84 tabs or 500 mls

Condition to treat if not on regular repeat medication list

Additional Information

Or scroll down to add more.

Drug Name

Strength e.g. 10mg

Frequency e.g. 2 tabs twice daily

Amount e.g. 84 tabs or 500 mls

Condition to treat if not on regular repeat medication list

Additional Information

Or scroll down to add more.

Drug Name

Strength e.g. 10mg

Frequency e.g. 2 tabs twice daily

Amount e.g. 84 tabs or 500 mls

Condition to treat if not on regular repeat medication list

Additional Information

Or scroll down to add more.

Drug Name

Strength e.g. 10mg

Frequency e.g. 5 tabs twice daily

Amount e.g. 84 tabs or 500 mls

Condition to treat if not on regular repeat medication list

Additional Information

Or scroll down to add more.

Drug Name

Strength e.g. 10mg

Frequency e.g. 6 tabs twice daily

Amount e.g. 84 tabs or 500 mls

Condition to treat if not on regular repeat medication list

Additional Information

Or scroll down to add more.

Drug Name

Strength e.g. 10mg

Frequency e.g. 7 tabs twice daily

Amount e.g. 84 tabs or 500 mls

Condition to treat if not on regular repeat medication list

Additional Information

Or scroll down to add more.

Drug Name

Strength e.g. 10mg

Frequency e.g. 8 tabs twice daily

Amount e.g. 84 tabs or 500 mls

Condition to treat if not on regular repeat medication list

Additional Information

Or scroll down to add more.

Drug Name

Strength e.g. 10mg

Frequency e.g. 9 tabs twice daily

Amount e.g. 84 tabs or 500 mls

Condition to treat if not on regular repeat medication list

Additional Information

Or scroll down to add more.

Drug Name

Strength e.g. 10mg

Frequency e.g. 10 tabs twice daily

Amount e.g. 84 tabs or 500 mls

Condition to treat if not on regular repeat medication list

Additional Information

Or scroll down to add more.

Drug Name

Strength e.g. 10mg

Frequency e.g. 11 tabs twice daily

Amount e.g. 84 tabs or 500 mls

Condition to treat if not on regular repeat medication list

Additional Information

Or scroll down to add more.

Drug Name

Strength e.g. 10mg

Frequency e.g. 11 tabs twice daily

Amount e.g. 84 tabs or 500 mls

Condition to treat if not on regular repeat medication list

Additional Information

Or scroll down to add more.

Drug Name

Strength e.g. 10mg

Frequency e.g. 13 tabs twice daily

Amount e.g. 84 tabs or 500 mls

Condition to treat if not on regular repeat medication list

Additional Information

Or scroll down to add more.

Drug Name

Strength e.g. 10mg

Frequency e.g. 14 tabs twice daily

Amount e.g. 84 tabs or 500 mls

Condition to treat if not on regular repeat medication list

Additional Information

Please note that requests made through this website are transmitted via email which may not be secure. You use this service at your own risk.

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