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 Address*

Phone No.*

Medication Required*

Collect from practice ($25.00)

Email to Pharmacy ($25.00)*

If you requesting the prescription to be emailed. Please enter the full name of your chosen pharmacy below.

RVMC now requires all prescriptions emailed to pharmacies, please enter the full name of your chosen pharmacy below.

There is currently a 48 hour change around time. If this is an URGENT prescription request please notify us in the “Medication Required” field.

Full Name of Pharmacy

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