Repeat Prescription Request

The following form is for existing Dokta patients to order repeat prescriptions for medication we have previously prescribed. New medications need to be discussed in an appointment.

Please complete as fully as possible. Your prescription will be issued within 24 hours of receipt.

NB. Not to be used for antibiotics or controlled drugs.

Each medication is clinically reviewed before being issued. In some cases, you may be asked to make an appointment to discuss your request.

Please enter a latest blood pressure if you are requesting blood pressure medicine, contraception or HRT. You can also do this separately by sending an email to: info@dokta.co.uk.

Explain any benefits you have experienced from taking this medication.

Describe any side-effects you think any medication may be causing?

Have you been diagnosed with any new medical problems or changed any regular medication since your last review?

Let us know if you have experienced any of the following:

Choose delivery of medication or prescription options.

NB. Emailed images of prescriptions with signatures are not legal or acceptable to pharmacies.

Only complete if you would like delivery to a different address to your home address

In order to continue with treatment