Prescriptions - Ballybrack Medical Centre

To request a repeat prescription, simply complete the form below. Your prescription will be sent to your nominated pharmacy within 2 working days. Please contact your pharmacy to arrange the time and date to collect your medication. It is not necessary to attend the surgery to collect your prescription.

Please note

if you are on blood pressure medications, HRT or contraceptive pill, you will require a yearly consultation.
if you qualify under the free contraception scheme, please phone reception to place your contraception prescription request.

"*" indicates required fields

Step 1 of 3 - About you

Your First Name*

Your Last Name*

Your Phone Number*

Your Email*

Your Date of Birth*

Your GP*

Sorry, this form is only for our current patients to request a repeat prescription

Do you have a valid medical / GP card?*

Yes

Please note a payment of €20 will be required to complete this form. Please have your credit or debit card ready

Please have your medical card or GP visit card number ready as it will be required to complete this form.

Information

We operate a policy of accepting prescription request forms by online/written request only. This policy is strictly adhered to and our admin staff members are not permitted to accept verbal requests for medication at any time. You can request your prescriptions by completing the online form above, or alternatively, print this form (PDF) and send it to us by post or drop it off at reception. This policy is in place to:

Ensure maximum patient safety;
Ensure that patients are aware of the medications they are requesting;
Reduce the risk of prescribing unnecessary medications;
Ensure accurate records of patient medication requests are retained;
Minimise human error

Some medications require a 6 or 12 monthly review or blood tests. In such cases, you will be required to make an appointment. In conjunction with best practice guidelines, we actively discourage prescribing benzodiazepines or sleeping tablets on an ongoing basis.