Requesting a Prescription with Wraysbury.com

Please fill in all the fields below. Your prescription will normally be ready within two working days, unless there is a queery, or for some other reason the prescription is delayed. We guarantee no level of service. The boxes must all be filled in accurately, if there is any doubt as to the required medication it will not be processed. You may only request medications that the Doctor has authorised for repeat.

 

Your Name

Date of Birth

Which Surgery

Medication requested, by Name (As it appears on the request form, or on the label on your current supply)

Your Patient Number (Appears on the repeat prescription form next to your name)

Phone Number Email address

Address

Other information, for example the reason you are requesting your medication early, or other information that will affect your request