Repeat Prescription Order Form

To make a request for a repeat prescription you must already have registered for our Collection and Delivery Service by registering online or filling in a form in-store. If you are unsure if you are registered please contact us. You must be the patient or have the patient's permission to submit this form. All fields are required, if you are not presented with the confirmation page after submitting this form then check the information you have provided.

Enter the characters from the picture below into the text box under neath. If you are unable to read the characters then click the blue and white arrow button next to it to get a new authorisation or click on the blue and white speaker button next to it to hear an audio clip instead.

Your order will now be submitted to Central Pharmacy to request from your Doctor. Please allow 3 working days before collecting from the Pharmacy or 3-4 working days for delivery if you have selected delivery when you registered with us.


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Company Registration Details

Superintendant Pharmacist: Amir Kabir (MRPharmS)

Company Registered Office:
Pharma Plus Medical LTD
Company Number: 07259684

H/O Address
7 Cecil Square