Request repeat prescription

Repeat prescriptions can be ordered by phone by choosing the option for our "recipe line", getting in contact with our assistent, or by using this repeat prescription form.

To be able to use this form you will have to be registered at our practice and the medication you order has already been prescripted to you by your physician our other medical specialist.

After submitting the form you will receive a confirmation email at the address given by you in the form. If requested before 12:00 and without furhter notice, your prescription will be available at the pharmacie after two working days after 16:00 in the afternoon.

Repeat prescription form

Repeat medication
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Fill in the information concerning the repeat medication and your pharmacy.

Medication

	Name	Potency	Amount	Dosage	Weight
	Name	Potency	Amount	Dosage	Item weight

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Pharmacy