Repeat Prescription Order Form

Please note: Due to Privacy Security, this form will not store your details or your medications. Please COPY exactly the details from your prescription slip that you received from the Practice. Once you send this form a notification message will appear to indicate successful submission, you will also receive the completed form in your email inbox.

You can now order online by completing the Repeat Prescription Order Form below:

Name *

First

Last

Email *

Confirm Email

Date of Birth *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Please select the appropriate number of repeat medications you need to order:

1 - 4
5 - 8

If you have more than 8 medications you can continue in the box at the bottom:

#1 Name of Medication and dose

#2 Name of Medication and dose

#3 Name of Medication and dose

#4 Name of Medication and dose

Please let us know your chosen Pharmacy for your prescription to be sent to:

The Castle Practice

The Health Centre | Taylors Avenue | Carrickfergus | BT38 7HU

Repeat Prescription Order Form

CONTACT

HOURS

POLICIES

LINKS

PBL Practice Closure

THE CASTLE PRACTICE

IMPORTANT PATIENT NOTICE

PLEASE NOTE THAT THE SURGERY WILL BE CLOSED FROM 1:00 PM ON

WEDNESDAY 17th SEPTEMBER 2025

AND WILL RE-OPEN AT 8:30 AM ON

THURSDAY 18th SEPTEMBER 2025

If you require URGENT MEDICAL CARE please call 028 9331 5804