Greenwich Peninsula Practice
Telephone  020 8312 8700    
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Telephone 0845 4647
www.nhsdirect.nhs.uk

   
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Please Note: The information sent by using this form is not encrypted and is no more secure than normal email. Complete confidentiality for this type of repeat prescription request can not be guaranteed. If you have an issue with this please feel free to use our normal repeat prescription service.

We aim to make your prescription available within 48 hours of your request.

Please note that if you have requested medication which needs to be re-authorised (your repeat medication slip will make this clear), you need to make a face-to-face or telephone appointment with a doctor.

 

Patients Name*  
Date of Birth*    
Address    
Contact Tel.*    
Email Address    
Collection  
*You must provide this information.
The items requested below MUST be on your regular repeat medication list.
   
 

     Item Description

Dose

 Quantity
       (e.g. Paracetamol) (e.g. 500mg) (e.g. 100)
       
Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
Item 7
Item 8
       
     
  * Please type the blue word above in lower case into the box below
(in order to help us reduce spam email)
   
       
   
Not for medical problems
   
Comments about this Prescription

 

                          

 

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