{"id":8320,"date":"2021-02-05T13:30:02","date_gmt":"2021-02-05T13:30:02","guid":{"rendered":"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/?page_id=8320"},"modified":"2023-08-02T10:55:12","modified_gmt":"2023-08-02T09:55:12","slug":"repeat-prescription-request","status":"publish","type":"page","link":"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/clinics-and-services\/services\/repeat-prescription-requests\/repeat-prescription-request\/","title":{"rendered":"Repeat Prescription Request"},"content":{"rendered":"\n<p><strong>Please allow up to 3 working days before collecting your prescription<\/strong><\/p>\n\n\n\n<p>If you take regular medication and are stable on this, your doctor will not need to see you each time you require a new prescription. They may issue you with a repeat prescription. You can request this be by using the form below or registering for Patient Access<\/p>\n\n\n\n<p>We are only able to accept repeat prescription requests for items which have been previously agreed by the doctor, which are suitable for repeat prescription ordering.&nbsp;Sometimes there may be reasons why we cannot issue a repeat prescription for some or all of the items and we aim to always let you know if that is the case.<\/p>\n\n\n\n<p>Acute prescriptions are medicines that have been issued by your doctor but not added to your repeat prescription records. This may be a new medication issued for a trial period, a medication that requires close monitoring or one that has clinical or prescribing restrictions linked to it. Acute prescription requests may require a review or phone appointment prior to the medication being added onto your repeat prescription records.<\/p>\n\n\n\n<p>In future you may wish to consider registering for our&nbsp;<a href=\"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/clinics-and-services\/online-services\/register-for-online-services\/\" data-type=\"page\" data-id=\"4028\">Online Services.<\/a> The Online Services system remembers which medications you are on and makes requesting repeat prescriptions faster and easier.<\/p>\n\n\n\n<p class=\"has-nhs-yellow-background-color has-background\"><strong>Please note:<\/strong>&nbsp;For reasons of privacy this form will not store your details or medication request. There is no email acknowledgement with this service. Once you send this form a notification message will appear to indicate successful submission.<\/p>\n\n\n<link rel='stylesheet' id='formidable-css' href='https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-content\/plugins\/formidable\/css\/formidableforms.css?ver=4271614' media='all' \/>\n<div class=\"frm_forms  with_frm_style frm_style_big_text\" id=\"frm_form_34_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_hnlsj6313\"  >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Repeat Prescription Request<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"34\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_34\" id=\"frm_hide_fields_34\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"hnlsj6313\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_34\" name=\"frm_submit_entry_34\" value=\"e7e38161d2\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/8320\" \/><div id=\"frm_field_866_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_half\">\r\n    <label for=\"field_xu1tj63132\" class=\"frm_primary_label\">First Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_xu1tj63132\" name=\"item_meta[866]\" value=\"\"  data-reqmsg=\"First Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_867_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_xt7az63132\" class=\"frm_primary_label\">Last Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_xt7az63132\" name=\"item_meta[867]\" value=\"\"  data-reqmsg=\"Last Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_868_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_ppbxb63132\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_ppbxb63132\" name=\"item_meta[868]\" value=\"\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_869_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_half\">\r\n    <label for=\"field_w1eya63132\" class=\"frm_primary_label\">Date of birth\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_w1eya63132\" name=\"item_meta[869]\" value=\"\"  data-frmmask=\"99\/99\/9999\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Date of birth cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\" pattern=\"\\d\\d\\\/\\d\\d\\\/\\d\\d\\d\\d$\"   aria-describedby=\"frm_desc_field_w1eya63132\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_w1eya63132\">Please use format day\/month\/year e.g. 12\/05\/1979<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_870_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_spq8l43132\" class=\"frm_primary_label\">Phone Number\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_spq8l43132\" name=\"item_meta[870]\" value=\"\"  data-reqmsg=\"Phone Number cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_871_container\" class=\"frm_form_field  frm_html_container form-field\">\n<h2>Prescription Items<\/h2>\n<p>Copy exactly the details from a prescription slip you have received from the practice.<\/p>\n<p>Please note that items will only be dispensed if they are included in a prescription from the practice and a medication review is not pending.<\/p><\/div>\n<div id=\"frm_field_872_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_52ks4\" class=\"frm_primary_label\">Item 1\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_52ks4\" name=\"item_meta[872]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_873_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_rhrsx\" class=\"frm_primary_label\">Item 2\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_rhrsx\" name=\"item_meta[873]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_874_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_6rasb\" class=\"frm_primary_label\">Item 3\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_6rasb\" name=\"item_meta[874]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_875_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_6kmlz\" class=\"frm_primary_label\">Item 4\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_6kmlz\" name=\"item_meta[875]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_876_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_rgh4e\" class=\"frm_primary_label\">Item 5\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_rgh4e\" name=\"item_meta[876]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_877_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_gh4pn\" class=\"frm_primary_label\">Item 6\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_gh4pn\" name=\"item_meta[877]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_878_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_admoj\" class=\"frm_primary_label\">Item 7\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_admoj\" name=\"item_meta[878]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_879_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_5u3lo\" class=\"frm_primary_label\">Item 8\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_5u3lo\" name=\"item_meta[879]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_880_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_k4esf\" class=\"frm_primary_label\">Item 9\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_k4esf\" name=\"item_meta[880]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_881_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_7le0y\" class=\"frm_primary_label\">Item 10\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_7le0y\" name=\"item_meta[881]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_882_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_upnnz\" class=\"frm_primary_label\">Special Medication Request\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[882]\" id=\"field_upnnz\" rows=\"5\"  data-invmsg=\"Special Medication Request is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_upnnz\"><\/textarea>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_upnnz\">Please Note: Special requests may not be authorised by the Doctor.<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_1407_container\" class=\"frm_form_field form-field  frm_required_field frm_hidden_container vertical_radio\">\r\n    <div  id=\"field_2ydqe_label\" class=\"frm_primary_label\">Pharmacy\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_2ydqe_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_1407-0\"><label for=\"field_2ydqe-0\"><input type=\"checkbox\" name=\"item_meta[1407][]\" id=\"field_2ydqe-0\" value=\"I have nominated a pharmacy and will arrange my collection from the pharmacy.\"  data-reqmsg=\"Pharmacy cannot be blank.\" data-invmsg=\"Pharmacy is invalid\" aria-invalid=\"false\"   aria-required=\"true\"  \/> I have nominated a pharmacy and will arrange my collection from the pharmacy.<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_884_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Privacy Policy<\/h3>\r\n\r\n\r\n<div id=\"frm_field_885_container\" class=\"frm_form_field  frm_html_container form-field\">This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our <a href=\"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/about-us\/practice-policies\/patient-record\/how-we-use-your-data\/privacy-policy\/\" target=\"_blank\">Privacy Policy<\/a> to discover how we protect and manage your submitted data.<br \/>\nPlease note: For reasons of privacy this form will not store your details or medication request. There is no email acknowledgement with this service. Once you send this form a notification message will appear to indicate successful submission.<\/div>\n<div id=\"frm_field_886_container\" class=\"frm_form_field form-field  frm_required_field frm_inline_container vertical_radio\">\r\n    <label for=\"field_4oeoa2\" class=\"frm_primary_label\"> \r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_886-884-0\"><label for=\"field_4oeoa2-0\"><input type=\"checkbox\" name=\"item_meta[886][]\" id=\"field_4oeoa2-0\" value=\"I consent to the practice collecting and storing my data from this form.\"  data-sectionid=\"884\" data-reqmsg=\"We need your consent to proceed. Please tick the box to consent.\" data-invmsg=\"  is invalid\" aria-invalid=\"false\"   aria-required=\"true\"  \/> I consent to the practice collecting and storing my data from this form.<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_1408_container\" class=\"frm_form_field form-field  frm_none_container\">\r\n    <label for=\"g-recaptcha-response\" id=\"field_y17l6_label\" class=\"frm_primary_label\">reCAPTCHA\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <div  id=\"field_y17l6\" class=\"g-recaptcha\" data-sitekey=\"6LdRuXYaAAAAAASCyd7HUA3auXaV7UOHkbyxnkX4\" data-size=\"normal\" data-theme=\"light\"><\/div>\r\n    \r\n    \r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t\t<div class=\"frm__654e4ddcbd5cd\">\n\t\t\t\t<label for=\"frm_email_34\" >\n\t\t\t\t\tIf you are human, leave this field blank.\t\t\t\t<\/label>\n\t\t\t\t<input  id=\"frm_email_34\" type=\"text\" class=\"frm_verify\" name=\"frm__654e4ddcbd5cd\" value=\"\" autocomplete=\"false\"  \/>\n\t\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"imo+qVs8NS2uaFZQAgJVefrzbLmcyeA4+5Rl6NHGZcM=\" \/><div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Send<\/button>\r\n\r\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n<\/form>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Please allow up to 3 working days before collecting your prescription If you take regular medication and are stable on this, your doctor will not need to see you each time you require a new prescription. They may issue you with a repeat prescription. You can request this be by using the form below or &#8230; <a title=\"Repeat Prescription Request\" class=\"read-more\" href=\"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/clinics-and-services\/services\/repeat-prescription-requests\/repeat-prescription-request\/\" aria-label=\"Read more about Repeat Prescription Request\">Read more<\/a><\/p>\n","protected":false},"author":6577921,"featured_media":8322,"parent":22,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","_uag_custom_page_level_css":"","footnotes":"","_links_to":"","_links_to_target":""},"acf":[],"uagb_featured_image_src":{"full":["https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-content\/uploads\/2021\/02\/npxxwgq33zq-scaled.jpg",2405,1600,false],"thumbnail":["https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-content\/uploads\/2021\/02\/npxxwgq33zq-150x150.jpg",150,150,true],"medium":["https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-content\/uploads\/2021\/02\/npxxwgq33zq-300x200.jpg",300,200,true],"medium_large":["https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-content\/uploads\/2021\/02\/npxxwgq33zq-768x511.jpg",768,511,true],"large":["https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-content\/uploads\/2021\/02\/npxxwgq33zq-1024x681.jpg",1024,681,true],"1536x1536":["https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-content\/uploads\/2021\/02\/npxxwgq33zq-1536x1022.jpg",1536,1022,true],"2048x2048":["https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-content\/uploads\/2021\/02\/npxxwgq33zq-2048x1363.jpg",2048,1363,true],"mailpoet_newsletter_max":["https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-content\/uploads\/2021\/02\/npxxwgq33zq-1320x878.jpg",1320,878,true]},"uagb_author_info":{"display_name":"Editor","author_link":"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/author\/gary-genpra\/"},"uagb_comment_info":0,"uagb_excerpt":"Please allow up to 3 working days before collecting your prescription If you take regular medication and are stable on this, your doctor will not need to see you each time you require a new prescription. They may issue you with a repeat prescription. You can request this be by using the form below or&hellip;","publishpress_future_action":{"enabled":false,"date":"2024-05-05 06:22:02","action":"change-status","newStatus":"draft","terms":[],"taxonomy":""},"_links":{"self":[{"href":"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-json\/wp\/v2\/pages\/8320"}],"collection":[{"href":"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-json\/wp\/v2\/users\/6577921"}],"replies":[{"embeddable":true,"href":"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-json\/wp\/v2\/comments?post=8320"}],"version-history":[{"count":3,"href":"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-json\/wp\/v2\/pages\/8320\/revisions"}],"predecessor-version":[{"id":13752,"href":"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-json\/wp\/v2\/pages\/8320\/revisions\/13752"}],"up":[{"embeddable":true,"href":"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-json\/wp\/v2\/pages\/22"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-json\/wp\/v2\/media\/8322"}],"wp:attachment":[{"href":"https:\/\/www.goringwoodcotemedicalpractice.nhs.uk\/wp-json\/wp\/v2\/media?parent=8320"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}