Repeat Prescription Request

Prescription Number & Product Name

This form is for repeats of medicines we have on our computer for you, NOT for new prescriptions you require. Please contact your Medical Centre for new prescriptions required.

If you require all of your medicines repeated just type “ALL” into the first medicine box. Please note that PHARMAC rules state that there must be at least 20 days (preferably close to 30) between dispensings of the same medicine. If there is less than 20 days or other questions we may have for you, we will not dispense the repeats until we contact you, or if we cannot we will have to wait and talk to you in the pharmacy.

If you only want some of the medicines we have repeats for on our computer, please write the prescription number and medicine name in the spaces below. The script number is the 6 digit number followed by a / then 0 or another number i.e. 1 . It is located at the bottom left of the medicine label. (e.g. 675043/2).

Repeat Prescription