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

COVID SPRING BOOSTERS

FOR PATIENTS AGED 75 AND OVER

AND ALL IMMUNOSUPPRESSED PATIENTS

FINAL CLINIC DATE

16.06.2026

WE WILL NOT HAVE ANY VACCINATIONS

AVAILABLE AFTER THIS DATE

WE HAVE BEEN CONTACTING PATIENTS BY

TEXT AND TELEPHONE CALLS

**PLEASE CONTACT THE

PRACTICE ANY DAY AFTER 11:00 AM

TO BOOK YOUR APPOINTMENT**

028 9331 5805

07513 985 168

07873 214 100

07873 211 433

CONTACT

HOURS

POLICIES

LINKS

** COVID SPRING BOOSTERS **

FOR PATIENTS AGED 75 AND OVER

AND ALL IMMUNOSUPPRESSED PATIENTS

** FINAL CLINIC DATE **

16.06.2026

WE WILL NOT HAVE ANY VACCINATIONS

AVAILABLE AFTER THIS DATE

WE HAVE BEEN CONTACTING PATIENTS BY

TEXT AND TELEPHONE CALLS

**PLEASE CONTACT THE

PRACTICE ANY DAY AFTER 11:00 AM

TO BOOK YOUR APPOINTMENT**

028 9331 5805

07513 985 168

07873 214 100

07873 211 433

COVID SPRING BOOSTERS

FINAL CLINIC DATE