Prescription Renewal Form

New UPDATE:  Please make sure to nominate your pharmacy on the form and we will deliver to them

North Gate Medical Centre operates a policy of accepting repeat prescription requests in written
form only. Our admin staff members are no longer permitted to accept verbal requests for medication at any time.

This policy is in place to;

  • Ensure maximum patient safety.
  • Ensure that patients are aware of the medications they are requesting.
  • Reduce the risk of prescribing of unnecessary medications.
  • Ensure accurate records of patient medication requests are retained.
  • Minimise human error.
  • Repeat prescriptions will only be issued within 5 days of being due and therefore we do ask that you only order your prescription within 7 days of being due.

We aim to have all prescription requests reviewed and delivered to your pharmacy within 5 working days. Please do not attend the surgery to collect your prescription.

Prescription Request Forms can be delivered to North Gate Medical Centre by the following means:

1. On Line– Please fill in and submit the on-line form below.

2. Hand delivery- Prescription Request can be dropped to the front door of the surgery, please make sure you have included the Patient’s Name, Address, Date of Birth along with the full list/names of each medication required.    Please also make sure that you have your Pharmacy Name included so that it can be delivered directly to them for your collection.