Patient Notice 

All requests for antibiotics will be rejected. To request antibiotics, please submit a triage request through the patient triage link here Contact us about your request - Accurx Patient PortalPlease note this service is available from 7.30am - 4pm Monday to Friday. 

Please fill in the form if you take a medication that is not on your repeat list.

The clinicians need all the following information to be able to process your request accurately; if the form is not fully completed your request will be denied.

Clinicians aim to complete these requests within 48 hours.

Please fill in a form for each item you require.

 

Acute Medication Request Form 

Required
Date of Birth Required
Required
Required
Required
Required
Required
Required
Required
Required
Date you last had this medication Required
Required