Cromer Group Practice

Cromer Group Practice

Please note that we do NOT accept Repeat Prescription requests by email, any received will be ignored. This online form is the ONLY accepted method for receiving online Repeat Presciptions.

All the information you need to complete this online form can be found on the paper Repeat Prescription form issued to you by your Doctor. It is important that we receive a fully completed online form containing the correct data in the order listed on the form otherwise a Repeat Prescription cannot be issued.

We can only accept Repeat Prescription requests for items listed on your paper Repeat Prescription form, unauthorised items cannot be dispensed.

If you would like this form to retain previously entered information you will need
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Repeat Prescription Form
 
Patient Name:
Address:
Date Of Birth:
Home Telephone:
Email Address:
       
  Item Description Strength Dosage
Item 1:
Item 2:
Item 3:
Item 4:
Item 5:
Item 6:
Item 7:
Item 8:
Item 9:
Item 10:
Item 11:
Item 12:
 
Chemist (prescription collection point):
   

Additional Information:

(This box can be used to give us your blood pressure readings)
 
 

Please allow 2 full working days to collect your prescriptions.