Unity Health

Kimberlow Hill Surgery | Wenlock Terrace Surgery

Repeat Prescription Request Form

Patient Details

The fields below marked with a red asterix must be completed

Contact details

If there are any issues with your prescription request we will need to contact you. *


Please allow 6 full working days for prescriptions to be processed and remember to take weekends and bank holidays into account.

If you require your medication sooner, please let us know in the comments.

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