020 8540 1009


If you are a member of the practice you can request a repeat prescription for long term medications which the doctor has agreed to put on repeat by completing the details below.

Please allow 2 working days for your request to be processed. Note on occasions the doctor may need to see you for review of your medication and health problems before issuing a repeat prescription.

All fields marked with an * are required.

Personal Details
Name: *
Email: *
Telephone: *
Membership number:
Address: *
Post code: *
Prescription details
Usual doctor seen:
Collection/Delivery: *
Number of items: *
Name of medication: *
Dose: *
Frequency taken: *
Quantity (agreed with your GP): *
Your comments
I agree to the terms and conditions: *
Terms And Conditions
Please note that by using this online form you will be sending information about yourself across the Internet. Whilst we endeavor to ensure that this information is kept secure, you should be aware that we cannot guarantee absolute privacy. You may prefer to select another method to order your repeat prescription if you are concerned about using the online form.

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Areas of GP Surgery Practice in London:

Wimbledon, Wimbledon Park, Putney, Earlsfield, Kingston, Southfields, New Malden, Worcester Park, Surbiton, Colliers Wood, Wandsworth, Clapham, Merton, Merton Park, Balham, Raynes Park, Battersea.

If you are outside of these areas please call and we will try and accommodate you.

We also cover the following as part of a premier package: Cobham, Esher, Fulham, Weybridge, Richmond, Chelsea and Barnes.

Please call for more information.