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 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

1 About you
2 Medications
3 Submit
Your Details
Do you have a valid medical card or doctor visit card?

A fee of €20 now applies to private prescriptions. Please have your debit or credit card details ready as payment will be required to complete your prescription request.

Please have your doctor visit or medical card number ready as it will be required to complete your prescription request.

Medications Required

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


Please submit your payment details below

€ 20
Stripe Card Placeholder
GMS Card Number

 This form is secured with 256-bit encryption



Your prescription will be forwarded to your nominated pharmacy and will be ready for collection at the pharmacy within 2-3 working days. Please do not attend the surgery to collect your prescription.


Should you wish to download a printable form please click here and return the completed form to us by post.

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