Repeat Prescription Request Form

If you have previously been supplied with at least one private prescription by Dr Sillifant or Dr Puri, you may now order your repeat prescriptions using the below form. Please note that we require two weeks' notice where possible to ensure time for request processing and allow for any difficulties, eg, low stock levels. Tell us in the notes section if you require a prescription earlier than this and we will do our best to accommodate. As per our schedule of fees, each prescription carries an administration/ postage cost of £20. Additional fees are likely to be added on collection of a privately prescribed medication from the pharmacy. These are, unfortunately, outside of our control, so any questions regarding these additional fees will need to be discussed between yourself and your pharmacist.