Aberlour Medical Practice

NHS

Queen's Road, Aberlour, AB38 9PR

Telephone: 01340 871210

Fax: 01340 882103

gram.aberlouradministrator@nhs.scot

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Medication Not on Repeat Online Form

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Home
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Medication Not on Repeat Online Form

Medication Not on Repeat Online Form

Form Completion

One form submission for each medication required

Please remember that it can take up to 48 hours, or 2 working days for the Practice to process your request; thereafter it can take another day for the Pharmacy to process.

Medication Not on Repeat

This form is to be completed for any medication that is not on your Repeat Prescription

Name*
First Last
Date of Birth*
Date Format: DD slash MM slash YYYY
Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Email
Telephone contact number*
Please let us know your main telephone contact number
When not to call*
Please let us know when we cannot call you. We cannot guarantee when we can call you. Enter N/A if we can call you at any time
Medication Name*
It is more helpful if the name is copied from the original packaging
Dosage*
Enter the dosage of the medication
How often taken*
How often do you take the medication
Prescriber*
Who prescribed the medication and when?
Reason*
Reason that the medication is taken
Date of last medication*
Date the last medication was prescribed
Date Format: DD slash MM slash YYYY
Additional Information
Please provide any additional medication that will help the Pharmacist, GP, or Prescribing Nurse with your request
CAPTCHA
Consent*
I agree to the privacy policy.
Signature*
Email
This field is for validation purposes and should be left unchanged.

Order your Prescriptions

Online Appointment Booking

Apply to register permanently at our Practice

Medication not on Repeat Order Form

Update your Details

Register for Patient Services - Repeat Prescriptions & Online Booking

Request for Medical Certificates

Temporary Resident

Patient consent

Opening Times

Monday
07:30 until 18:00
Tuesday
08:00 until 18:00
Wednesday
08:00 until 18:00
Thursday
08:00 until 18:00
Friday
08:00 until 18:00
Saturday
CLOSED
Sunday
CLOSED

Useful Links

Complaints

Language Line Interpreter Services

NESS Interpreter

Medication Not on Repeat

Travel

Temporary Resident

The House of Care

NHS 111

NHS Choices

Patient UK

House of Care

Update your Details

Name*
First Last
Date of Birth*
Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Landline Telephone*
Mobile Telephone
Email*
Smoking Status*
How many per day?*
Consent
I agree to the privacy policy.
CAPTCHA
Privacy*
- By using this form you agree with the storage and handling of your data by this website.
Comments
This field is for validation purposes and should be left unchanged.

Patient consent

Name*
Prefix First Last
I am a patient of Aberlour Medical Practice and understand I need to give consent for another individual to have access to my medical records and/or to discuss my medical requirements. I understand the contact details of the individual will be recorded on my medical record.
Date of Birth*
Date Format: DD slash MM slash YYYY
Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Nominated individual - Full name*
Telephone number*
Relationship to patient*
CAPTCHA
Signature*
I understand if any of the consent contact details change or I wish for them to be removed from my medical record I will contact the Practice immediately.
Date*
Date Format: DD slash MM slash YYYY
Comments
This field is for validation purposes and should be left unchanged.

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