Rosemary Medical Centre

PLEASE GIVE TWO WORKING DAYS’ NOTICE FOR REGULAR REPEAT PRESCRIPTIONS.


CONFIDENTIALITY - TERMS AND CONDITIONS: The internet is not secure, and the transmission of data to request medication is entirely at the patient's own risk. The practice accepts no responsibility for breaches in confidentiality resulting from patients' transmissions.

Please Enter Your Name

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Date Of Birth dd/mm/yyyy (*)

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Telephone Number

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Your Email Address (*)

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Usual Doctor (*)
Please SelectDr Steven WarlowDr Colin PughDr Jo WiselyDr Sue GarlandDr Alex JohnstoneDr Surita Alner
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FOR EACH MEDICATION PLEASE LIST NAME, FORM (eg TABLETS, SUSPENSION), DOSE AND FREQUENCY


Example 1: Omeprazole tablets 20mg once daily


Example 2: Amoxicillin suspension 125mg/5mls take 5mls three times daily

Medication 1 (*)

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Medication 2

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Medication 3

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Medication 4

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Medication 5

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Medication 6

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Medication 7

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Medication 8

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Medication 9

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Medication 10

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Comments

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