Request A Repeat Prescription Online Form

If you do not have a Patient Access/EMIS online services account you can use the form provided below to request any repeat prescriptions from Highview Medical Centre. Please allow 48 working hours before collecting your prescription after sending through your request.

Please reorder only those items which you need and inform us of any medication that you no longer require on your repeat list. You can request that a nominated pharmacy collects your prescription on your behalf. If you choose to do so please let the pharmacy know that you have requested a repeat prescription and when you expect it to be ready to collect.

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Medication Required

Item Description
Strength
Quantity