Repeat prescriptions can be ordered by filling in the form below. Patients generally need to be seen on a six monthly basis for ongoing renewal of prescriptions. Any exceptions are at the doctors’ discretion.

A charge of €20 applies for all private prescriptions without a consultation. You will be sent a text with a secure link to pay the Private Prescription Fee after you have requested the prescription.

Medical Card and GP Visit Card patients have their fees paid for by the State.

PLEASE ALLOW 2 WORKING DAYS TO PROCESS ALL PRESCRIPTION REQUESTS.

Please check with your nominated pharmacy that they have received your prescription before you call us to check if we sent it.

Phone Requests for Prescriptions are not accepted.

Order Prescription

First Name

Last Name

Date of Birth

Please use format as shown

Email

Mobile Phone

(###)

###

####

Pharmacy Name

You prescription will be sent electronically to your nominated Pharmacy

Number of Items Required

Name and Dose of Requested Medication

Please list all medication required

If you are only ordering some of the medications on your script please note here what you are leaving off and why. e.g. No longer needed, or have enough for another month etc.

Patient Type

Private Patients will be sent a text to pay the €20 fee

Private

Medical Card Holder

Doctor Visit Card Holder

CIE/Garda Scheme

By using this form you will be sending personal/sensitive information about yourself across the Internet. Please read our privacy policy to discover how we protect and manage your submitted data. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method of contacting the practice.

Prescriptions

Order Prescription

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