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 Prescription Refill Request
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This prescription from is for use for established clients only. Pets for which prescriptions are requested must have been examined within the last 12 months.

This refill form is for the convenience of our clients that have previously been prescribed a medication by one of our veterinarians. Your request will be reviewed by a veterinarian and you will be contacted if the refill is denied for any reason.

An email confirmation will be sent if your prescription request was fulfilled.

If your pet is taking medication for a chronic problem, your refill request may be denied until the proper bloodwork and/or testing is performed.

Federal and State laws prohibit us from dispensing prescription medications without prior examination (within the past 12 months) and current knowledge of your animal's health.

We are similarly prohibited from dispensing or refilling medications that were originally prescribed by another veterinarian.
  Prescription Refill Request Form  

Diet and Nutrition Diet and Nutrition
 A proper diet can help
your pet live a longer,
healthier life


* Owner / Client Name:

* Owner / Client Email:
(Be sure to list the info after @)

Cats & Dogs
Client ID :
(If known)

* Phone # Home:
(Please include area code)

Phone # Work:
(Please include area code)

* Phone # Cell:
(Please include area code)

 

Best Time To Call:

 

* Pet's Name:

 

* First Medication Requested

* Dosage size/strength  
* Quantity Requested  
***** *****  

Second Medication Requested

Dosage size/strength

Quantity Requested    
***** *****    
Third Medication Requested    
Dosage size/strength    
Quantity Requested    
***** *****    

Date you would like to pick up your pet's medication

 

IMPORTANT:

Please allow 24 hours after submitting this form for us to fulfill your presciption request.

Please call us at 692-3331 before you come in to make sure that your pet's presciption is ready.

* Indicates required information

 
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