You can order repeat prescriptions by completing the form below.
Be sure to enter either a phone number or email address in the 'contact details' box in case we need to contact you.
If you wish to collect your prescription from either Burghfield
or Mortimer Chemists please select from the options below.
Please provide as much information as possible including the drug name and strength.
If you require more than 10 items simply 'send' then return to this form and send a second request for the extra items.
Please note that information you send over the internet is not encrypted as we do not ask for any details which may be deemed confidential. However, if you have any concerns please use an alternative method to request your prescription.
Items required :
I wish to collect from:
Mortimer Surgery
Lloyds (Mortimer Chemist)
Burghfield Chemist