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Shotfield Medical Practice Providing NHS services
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Home > Repeat Prescription

Repeat Prescription

To request a repeat prescription, please enter your personal details below, followed by the name, strength and quantity of medication you require. Please allow at least 72 hours before visiting your collection point.

We can only process requests for repeat prescriptions - if you require a new medication you will need to book an appointment, to speak to one of our doctors on the telephone.

This will be monitored Monday to Friday, 8.30am to 12.00pm.

Do not use for urgent prescription requests.

Remember to nominate a pharmacy, so you can pick your prescriptions up directly from them.

Your Details
DD/MM/YYYY
This will allow us to locate you quickly on our Patient Database.
Your Address
Your Contact Details
Prescription Details
Medication Required

Medication 1

Medication 2

Medication 3

Medication 4

Medication 5

Medication 6

Medication 7

Medication 8

Medication 9

Medication 10


Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.


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Shotfield Medical Practice

Shotfield, Wallington, Surrey, SM6 0HY

  • 020 8669 7612
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Local Services
Aesthetic
Clinic
Funeral
Plans
Home
Care
Home
Care
Jobs
Residential/
Nursing Care
Private
Dentist
Counselling