575 Mt Eden Road
Phone: 623 4599

Repeat Prescriptions

Repeat prescriptions for some regular medications may be obtained without making an appointment.  These can be done for enrolled patients only.  If we have not prescribed the item for you before, you will need to see your doctor.  We may not provide repeats if you were not seen for your last script, you are on multiple medications, or your medication was changed at your last visit.  We will contact you if an appointment with your doctor is needed. 

You can request a repeat prescription by using the form below or by speaking to one of our nurses by phone.  You may request to collect your prescription, have it faxed to a pharmacy or mailed to your home. 

Your prescription request will be actioned within 48 hours. (There may be a delay over weekends and public holidays).  Please allow sufficient time for mail delivery.

Please note that urgent same day scripts will incurr an additional $10.00 fee.

This form is not available on mobile - to use this form please view on a desktop computer or tablet.


Enter your contact information:
Please complete all fields.

Full Name:  
Date of Birth:  

Contact Phone Number:




Usual Doctor:   
Medication Required:
Please included dosage




I am currently well
I have the following concerns:
(You may be requested to see your doctor.)


Have you seen another doctor or changed medications since your last prescription with us?:



(Please detail changes below)  



Choose how to collect your script:
(You must select one)


Collect from the practice ($15.00)

Mail to my home address ($15.00)

Fax to a pharmacy ($25.00)

    (Please fill in all fields below)
Pharmacy Name:


Pharmacy Fax:  
Mailing Address:  



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