The Hollies Surgery

HOW DO I....
OBTAIN A REPEAT PRESCRIPTION?

Requests for repeat prescriptions may be handed in at reception or placed in the box near the front door. Please use the form which is attached to your prescription whenever possible. If you include a stamped addressed envelope we can send your prescription to you. Prescription requests can also be accepted by fax and email but not over the telephone.

Please request all the items you may need to last you a full month. You should allow two working days before collecting your prescription although same-day collection may be available in exceptional urgent cases.

HOW DO I....
OBTAIN A SICK CERTIFICATE?

We provide, in the reception, SC2 forms (self-certifying) which cover your first week off sick.

NI certificates (Form Med 3) are only available from your doctor and commence after one week of absence from work. If your employer requires a private certificate, a standard fee will be charged. Hospital wards and out-patients are able to provide routine certificates.

REPEAT PRESCRIPTION REQUEST FORM

* = Required field

First Names:

Last Name:

Date of Birth
(dd/mm/yyyy):

Email Address:

Phone Number:

Your Usual Doctor:

Please tell us the drugs you require. Be specific and check your spelling. Please take all details from your repeat prescription record slip.

Drug Name	Strength
*

If you require more than 10 items, please submit another request.

Collection Point :

Comments:
(any comments that you may have about this service, or additional medication)

CONFIDENTIALITY - TERMS AND CONDITIONS:
The internet is not secure, and the transmission of data to request medication is entirely at the patient's own risk. The practice accepts no responsibility for breaches in confidentiality resulting from patients' transmissions.

I accept the terms and conditions above*