01 287 4275 | E-Doc Out of Hours 01 223 4500


Greystones Medical Centre operates a policy of accepting prescription request forms by written request only. This policy is strictly adhered to and our admin staff members are not permitted to accept verbal requests for medication at any time. This policy is in place to:

  • Ensure maximum patient safety.
  • Ensure that patients are aware of the medications they are requesting.
  • Reduce the risk of prescribing of unnecessary medications.
  • Ensure accurate records of patient medication requests are retained.
  • Minimise human error.

Online Prescription Request

To request repeat prescription please complete the form below

Note: if you have more than one item, simply start typing and further lines will appear as soon as the current one is completed.

1 Step 1
Prescription Order Form
First Name
Last Name
Date of Birth
Phone Number
#1 Medication
#2 Medication
#3 Medication
#4 Medication
#5 Medication
#6 Medication
#7 Medication
your full name
#8 Medication
#9 Medication
#10 Medication

 This form is secured with 256-bit encryption



We aim to have all prescription requests, which are received before 12 noon, reviewed within 2 working days. Please do not attend the surgery to collect your prescription prior to this period.

Should you wish to download a printable form please click here and return the completed form to Greystones Medical Centre by the following means:

  • Hand delivery; during opening hours – please place in Request Box at Reception;
  • Hand delivery; during closed hours – please post through the letterbox on the front door;
  • Post – please post to Greystones Medical Centre, Mill Rd, Greystones, Co. Wicklow;



We would like to advise our patients that the doctors in Greystones Medical Centre are participating in E Doc, which is the new urgent care service providing extended GP care at nights and weekends. Available between 6pm and 8am Mon-Fri and 24 hours at weekends and bank holidays. Phone 01 2234500.