Repeat Medication Order Form
Indicates required field
Date of Birth
If you are aged 65 years or over OR in an at risk group and wish to have the flu vaccine please book a vaccine on our website.
We may need to contact you in relation to prescription request.
Select Your Regular GP
Select Your Preferred Pharmacy. We will arrange for your prescription to be passed to any of the Pharmacies listed below
Select Your Pharmacy
Lynch's Pharmacy Virginia
McCrystal's Pharmacy Virginia
O'Donoghue's Pharmacy Virginia
Gormley's Pharmacy Ballyjamesduff
Green's Pharmacy Ballyjamesduff
Lynch's Pharmacy, Oldcastle
McQuaid's Pharmacy, Oldcastle
McNally's Pharmacy, Mullagh
Cara Pharmacy, Bailieborough
Jameson's Pharmacy, Bailieborough
Other - please provide pharmacy name, location and healthmail email address in box below
Select your preferred Pharmacy and we will forward your prescription directly to them - please allow 48 hours
Please list Long Term Medications Required below [Medication name, strength and dosage is required] If medication is not listed in full we can not issue this prescription request. e.g. we are unable to issue requests such as "usual medications", "full prescription", "blood pressure tablets". Thank you for your understanding.
Please list the drug name, strength and how often you take your medication eg. Paracetamol 500mg 2 tablets twice a day
Please allow 3 working days for your Repeat Prescription to be prepared and sent to your choice of Pharmacy. It is important to list your medication names, strength and dosages as omitting this information may result in us being unable to follow up on this request. Please note only long term medications can be requested using this form. Please do nominate a pharmacy and we will notify them directly. Please note we are unable to respond to other query using this form. Our lines are extremely busy at present but please do bear with us as we work through these changing times. .
Please do not present to the surgery without speaking with us first, this is for your safety as well as the safety of our staff. We appreciate your patience and understanding.
Please Click on
" to forward your request. Many thanks.