Request a Prescription

PLEASE NOTE that there is a 24 hour turnaround for repeat prescription.
If this is a urgent request please phone the surgery (09) 524 5547, option 1.
We will contact you if we have any queries with your request.

Items marked with (*) are essential & MUST be completed.

Your Name*

Date of Birth*

Email*

Phone No.

Medication Required*

Fax to Pharmacy*

�All prescriptions must be faxed to pharmacies. Please enter the full name of your chosen Pharmacy below.

There is currently a 72 hour change around time. If this is an URGENT prescription request please notify us in the “Medical Required” field.

Full Name of Pharmacy

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