Prescription Request

Please Note:

1. We have recently found delays between web-based prescription requests being made and receipt of these at our email server at the practice. We have therefore decided to send an automated confirmation that your request has been received at Hathaway Medical Centre. You will now receive two emails from us. The first email will confirm the details of the request that you have sent to us. The second email will be sent once your request has been received at the practice. The time before collection will not change and begins when we have received your request at the practice. You must allow 2 full working days for collection from the practice and a minimum of 3 full working days for collection from a pharmacy.
2. This form must only be used to request medication that is currently authorised for re-issue. Please ensure you enter a valid email and telephone number in case we need to contact you. In an emergency please contact us directly.
3. This form is sent to us in a non-encrypted format via computers that do not belong to the NHS. Complete confidentiality for this type of repeat prescription request can not be guaranteed. If you have an issue with this please feel free to use our normal repeat prescription service.

First Name:	*
Last Name:	*
Date of Birth:	(dd/mm/yyyy)
Medication:	*
Collection Point :	Surgery Lloyds for delivery Lloyds HMC Lloyds Rowden Boots Morrisons (Safeway) Sainsbury Co-op(Pewsham) *
Tel:	*
Email:	*

You will no longer receive confirmation that your prescription has been printed, but we will contact you directly if we envisage a delay.