Prescription Order Form
The prescription request form can be collected from reception or alternatively you can fill out the form below.
*Please ensure you list each medication you require
The charge for a repeat private prescription is €20.
It is your responsibility to ensure your prescriptions are renewed when you collect your last script from the pharmacy. Please place your order in sufficient time to ensure you do not run out of medication.
PLEASE NOTE: We do not accept requests for Repeat Prescriptions over the phone. Please complete this form by listing the items you require and submit. All Repeat Prescriptions take 72 hours (3 Days) to process.