New patient repeat medication request

When you register with a new surgery, medications you had on “repeat” at any previous surgery do not automatically carry over to our surgery. This is for safety reasons. Our doctors ultimately take responsibility for any prescription we issue, even if the course was initiated by a doctor elsewhere, so we like to make sure that the medication is right for you.

Please complete the below form with as much information as you can.

You can complete the form using Adobe Acrobat Reader – instructions can be found here – or by printing it out.

New Patient Repeat Medication Form (MS Word / ODT) New Patient Repeat Medication Form (PDF)

ADHD Medication

When you register with a new surgery, ADHD medications you had on “repeat” at any previous surgery under a shared care agreement do not automatically carry over to our surgery. This is for safety reasons. Our doctors ultimately take responsibility for any prescription we issue, even if the course was initiated by a doctor elsewhere, so we like to make sure that the medication is right for you. Please complete the below form to make the process of transferring as easy as possible.

New patient ADHD shared care transfer request form (Word / ODT) New patient ADHD shared care transfer request form (PDF)

Last modified: March 5, 2024