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Repeat prescripiotn request
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Repeat Prescription Request

Name Date of Birth
Address Email address
Contact number

Post Fax

number

Doctor Lisa Fay Paul Carson    

 

 

 

 

 

 

 

 

Name of medication Dosage Number Taken How many times per day Repeat

• Please allow at least 24hours from submitting to collecting prescription

• Prescriptions can be collected from Reception on 1st floor during normal working hours - Monday, Thursday and Friday 8.30am to 6pm, Tuesday and Wednesday 8.30am to 7.30pm and Saturday 10am till 1pm.

• Please note that if you are requesting a Contraceptive Pill prescription you must see Dr Fay at least every 6 months for a blood pressure check. (See Pill Check page)

 
First Floor, Slievemore Clinic, Old Dublin Road, Stillorgan, Co Dublin
Phone 01 2000 500 Fax 01 2101 594 Email receptionthree@slievemore-clinic.com