The Harrow Health Care Centre

Repeat Prescription Request Form

When ordering a repeat prescription we require a written request, using the form below, in order to ensure accuracy, safety and efficiency. This form may be returned to us by email, fax, post, or in person at reception. We will provide repeat prescriptions of those medications which you have previously received from us, and for which you have regular annual or other review with a Doctor here at Harrow Heath Care Centre. The name of the drug, the dose and how often to take it are marked on the label of your medication. Please tell us the quantity required and the length of time you wish it to cover. Repeat prescriptions may incur a fee. For details please see below and our website.

Please complete the request FULL IN CAPITALS to avoid queries and delay.

Repeat prescription

Please complete the form below, up to 10 drugs can be selected per submission. Changing the number of drugs clears your repeat prescription form drugs fields for fresh entry. To return a repeat prescription by post, fax or email, please click here and choose ‘Request Repeat Subscription Using Word.doc’.

[contact-form-7 id=”8617″ title=”Repeat Prescription Request”]