Prescriptions

 

This email request system is for our enrolled patients with stable conditions requiring repeat prescriptions. In general you will need to be seen every 6 months for review so this form will allow a repeat script between review visits. We are still operating the usual phone request and written request system of repeats but think that this email option may be quicker and easier for many.

This email will be checked once a day (approximately midday) by the nurses and scripts will be ready by the next day. Urgent (same day) requests will still need to be made by phone or by dropping a written request in to the surgery.

    Your Name (required)

    Your Address (required)

    Your Date of Birth - format 10 Jan 1975 or 10-1-75 (required)

    Your Email (required)

    Your Phone Number - landline or mobile (required)

    Subject

    List medications requested. List medication name and dose from pharmacy label.
    Indicate in the checkbox below whether you will collect your script of if you want it faxed.
    If you want it faxed to another pharmacy please enter pharmacy name, address and fax number after your list of medicines.

    I will pick up my script from the surgeryFax my script to Kawerau Pharmacy pleaseFax my script to Tarawera Pharmacy pleaseFax my script to K Town Pharmacy pleaseFax my script to another pharmacy please