To Order your repeat prescription please fill out the form below.

Patient Name

Patient Date Of Birth

Please note that dates MUST be in the format of DD/MM/YYYY ie: 21/02/1950.

Daytime Contact Number

Patient Post Code

Email Address

Collection Location

Patients should be advised that all prescriptions will be sent to Eyemouth Pharmacy unless an alternative option is selected below.

Eyemouth PharmacyChirnside PharmacyDuns PharmacyCollect Paper Prescription from Eyemouth Health Centre

*Collect paper prescription in person from Eyemouth Health Centre option should be selected for use of any other community pharmacy.

Prescription Required:

Please be sure to include your prescription strength and quantity, For example: Paracetamol, 500g 1 Pack.

Please use an individual line per drug required.

Check this box for antispam