Repeat Prescription Form - Working UI

For more details on how to order repeat prescriptions:

NHS Repeat Prescription Guide

Repeat Prescriptions

Please fill in your information below

NHS No.
Birth Date
Name
Phone
Email
Address & Surgery
Prescription
Finish

NHS Number:

Step 1 - 8

NHS number (optional):

NHS number must be exactly 10 digits or leave this blank.

Date of Birth:

Step 2 - 8

Date of birth: *

Personal Information:

Step 3 - 8

Full Name: *

Contact Information:

Step 4 - 8

Phone Number: *

Contact Information:

Step 5 - 8

Email Address: *

Address & Surgery:

Step 6 - 8

Home Address: * GP Surgery Name: *

Prescription Details:

Step 7 - 8

Please list the medications you need: * Include medication name, strength, and quantity for each item.

Upload a photo of your repeat prescription (optional): Accepted files: JPG, PNG, PDF. Max size 5 MB.

Patient Consent

Step 8 - 8

Patient Consent Required

Do you give your consent for TheOnlineChemist.uk to manage your prescription?

VALUE

Our team will expertly check, dispense, and pack your prescription items.

convenience

Free UK Delivery on all Prescription Orders

TRUST

Regisered and Regulated UK Pharmacy with NHS services.

Why Choose Us

We provide trusted pharmacy services with expert guidance, quick prescription delivery, and reliable health consultations to support your wellbeing.

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Pharmacists

FREE

Delivery

Your Prescriptions, Delivered with Ease . . .

Choose and nominate our pharmacy to receive your electronic prescriptions.
Your GP sends the prescription directly to us electronically.
We prepare and dispense your medication promptly and efficiently.

Get In Touch

First Name *

Last Name *

Email *

Select Priority

Subject / Order No

Message

Repeat Prescriptions

NHS Number:

Step 1 - 8

Date of Birth:

Step 2 - 8

Personal Information:

Step 3 - 8

Contact Information:

Step 4 - 8

Contact Information:

Step 5 - 8

Address & Surgery:

Step 6 - 8

Prescription Details:

Step 7 - 8

Patient Consent

Step 8 - 8

Finish:

Step 8 - 8

SUCCESS!

Your request has been submitted

Why Choose Us

Pharmacists

Delivery

Your Prescriptions, Delivered with Ease . . .

Get In Touch

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