Repeat Prescription Request Form
Have You Visited The Dr in The Last 12 Months
Do You Have A Full Medical Card?

Thank you. Your prescription request has been submitted.

This will be reviewed by a doctor and sent to your chosen pharmacy within 3 working days.

If there is an issue with the request you will be notified on the mobile number provided.

Please Note: Private prescription requests are subject to a €20 Fee. This can be processed by phoning 01-8373611