Thank You For Your Prescription Refill Order

Thank you for your Prescription Refill request

If you wish to request an additional refill just complete the required information and submit. It’s that simple! Our staff will email or telephone you if there is any difficulty with your request. Please note that various regulations and our concern for the best interest of your pet require that one of our veterinarians has examined your pet within six months prior to your request to refill a prescription.

NOTE: Online prescription refill requests received after 1:00 p.m. on Friday will not be processed until Monday morning after 9:00 a.m.

Top of Form

———————————————————————————————–

Client’s Name:

Patient’s Name:

Will you pick up the order at our office or do you wish us to ship the order to you?

I will pick up the order.

* Please ship my order to the following address:
Shipping address:

We are only able to process and ship prescription refill requests for clients who have their credit card information on file with us. Do we have your credit card information on file?

Yes

Name of Medication:

Strength of Medication and whether Tablets or Liquid:
(i.e. 5 mg tablets, 6C)

Quantity Requested:
(i.e. 25 tablets)

Current directions for administering this medication:
(i.e. 1 tab 3 times/day)

Your Pet’s Doctor:

Your email address for verification and notification:

Your telephone number:

* Please be advised that a shipping charge will apply.

Comments are closed.