Link to Contraception Request Form Repeat Prescription Form Please allow up to 2 working days before collection, thank you Please enable JavaScript in your browser to complete this form.First Name *Last Name *Date of Birth *Address *Mobile Number *Home TelephoneEmailMedication Required *For clinical safety purposes we require the names of your medication. Your request may be rejected if you input "my diabetes medication"Nominated Pharmacy *Osbon Pharmacy - 143 Lambeth Walk - SE11 6EETesco Pharmacy - Kennington Lane - SE11 5QUHills Pharmacy - 99 Kennington Lane - SE11 4HQMedimex Chemist - 222 Kennington Park Road - SE11 4DALloyd's Pharmacy in Sainsburys - 62 Wandsworth Road - SW8 2LFVitelow Pharmacy - 26 Clapham Road - SW9 0JGOther [please include name and postcode]The Vauxhall Surgery can send your medication electronically to a nominated pharmacy of your choice to be ready for collectionNominated Pharmacy [Other]Message for GP (if required)PhoneSubmit Register for Patient Access to book appointments, request medication and view your medical record online.Click below for more details