Only existing patients of DoctorNow can request repeat prescriptions by completing the form below.
Fields marked with an * are required.
Date of birth*
Name Of medication required*
Quantity (+/- how may taken, how many times per day)*
RemoveAdd another medication
How would you like to be informed when your prescription is ready?*
—Please choose an option—SMSEMAILTelephone
When ideally is the prescription required by?*
How would you like to receive your prescription?*
—Please choose an option—Collect from the practiceFax to PharmacyPost to home addressTotally Pharmacy
Please provide any further information