OLD prescription form

We now have two versions of our online prescription ordering form. This version is our first and oldest and may suit those with ‘Windows 98’ computers or older. We recommend that you try our new form (it may require a small download and installation of some software) as the new form has a much more robust method of delivery and can provide receipts for your request.

You can select the NEW form from the menu on the left of this website. 

Online repeat prescription form. This can only be used for repeat prescriptions. Any other ‘acute’ or one off requests must be approved by your doctor via the normal means.

Cut off time. Prescriptions are checked daily by our reception team. Any requests received after 11:00am will not be processed until the following day.

How long will my prescription take to be ready?
Please allow for 48 hours, excluding weekends or holidays. It will take up to two working days for your prescription to be ready.

Please note: This form is sent to us via computers that do not belong to the NHS and the data is in a non-encrypted format. Complete confidentiality for this type of prescription request can not be guaranteed. If you have an issue with this, please use our normal repeat prescription service.

Please scroll down for the repeat prescription form. 
Ardersier Medical Practice repeat prescription form. (SH v2)































Full name: *
Address: *
Postcode: *
Date of Birth: *
Contact phone number: *
Mobile phone number:
Repeat prescription request:
Please give drug names in full, including dosage and strength as indicated on your previous prescriptions. This form should only be used if you are requesting medication currently listed on your repeat prescription medication form.

If you require an item that is not listed on your form, please hand in or post a request instead.

Medication, item 1: *
Medication, item 2: *
Medication, item 3: *
Medication, item 4: *
Medication, item 5: *
Medication, item 6: *
Medication, item 7: *
Medication, item 8: *
Medication, item 9: *
Medication, item 10: *
Medication, item 11: *
Medication, item 12: *
Where would you like to collect your prescription from?

The Ardersier Medical Practice premises.
Nairn - Douglas Street premises.
     Ardersier Pharmacy.
     Nairn 'Boots the Chemist'.
     Nairn Lloyd's Pharmacy.
     Croy Shop. Does not operate on Thursday. Please be aware that this Croy service is run on a goodwill basis by the Ardersier Pharmacy only.
Any other comments:
(Not for medical problems)
  On pressing the send button, you will be redirected to a confirmation screen.

 

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