If you would like to order your repeat prescriptions online, please complete this form. It takes 48 hours to prepare a prescription.

Although repeat prescriptions are issued for medications that we want you to take continuously this does not mean that you do not require regular review of your health so we won't issue medication if you are overdue or miss a medication review appointment.

Please note that the information is not encrypted before arriving at our mailbox so if you are not happy to email personal information do not use this facility

* indicates required fields. If you need help in filling in the required data  click here.

*Surname      *First Name   

*Patient number

*Date of Birth(dd/mm/yy)   Email address

*Medication name                *Strength                       Quantity

please make one selection from the following list to indicate what you want us to do with your prescription

I will pick up prescription

Give to Fortam's Chemist

Give to Lloyds Chemist, Church Street

Give to Lloyds Chemist, Lutterworth Medical Centre