Hillrise Pharmacy - Prescription Service

3 steps to easy prescription services at Hillrise Pharmacy

Step 1
One week before your regular medication runs out, inform Hillrise Pharmacy.

You can either:

Use the repeat prescription form below
Phone
Fax
Email
Or pop into the pharmacy

Step 2
Hillrise will contact your GP and collect your prescription, unless your GP insists on seeing you.

Step 3
Pop into Hillrise at the agreed time and your medication will be ready waiting for you or the medication will be delivered to housebound patients.

Repeat Prescription Form

This service is only available to patients who have a valid, up-to-date, repeat prescription.

First Names:
Last Name:
Date of Birth:	(dd/mm/yyyy)
Address:
Phone Number:
Email Address:
Doctors Surgery:

Please tell us what medication you require. Be specific and check your spelling. Please take all details from your repeat prescription record slip.

Drug Name	Strength

If you require more than 8 items, please submit another request.

Comments (any comments that you may have about this service)

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 Pharmacy accepts no responsibility for breaches in confidentiality resulting from patients' transmissions.

I accept the terms and conditions above and understand that by ticking this box I give my consent for Hillrise Pharmacy to order, pick up and dispense this repeat prescription.

Repeat Prescriptions

3 steps to easy prescription services at Hillrise Pharmacy

Repeat Prescription Form