Rx Refills

Refill Request

To prevent confusion, each form is only good for 1 pet. For multiple pet medication requests please submit one form for each pet. Medications will only be shipped/ready for pick up after invoice has been paid. Please allow 2-3 business days for processing.
Name of Owner (As Listed on MVS Account)*

First NameLast Name
Phone Number*
Please enter the phone number we need to contact for any questions regarding this request.
Email*
As Listed on MVS Account
Pet Name*
Just 1 pet. If you need to request refills for multiple pets, please submit a request form for each individual pet.
How many medications will you be requesting refills for?
Please only select the number of refills you will be requesting for the pet you have listed on this form. For other pets, you will need to submit additional forms. Likewise if you need more than 3 medications you will need to submit an additional refill request form.

Preferred Delivery Method*
Please read all options and contact us with any questions.
MVS is happy to provide you with a written prescription, mailed via USPS, for you to fill medications for your pet at the pharmacy of your choosing and at your convenience. Exceptions to this policy may be made at the discretion of MVS in the event of an emergency or other special circumstance.
Medications will be shipped via USPS and a tracking email will be sent to the email we have on your account. USPS does not guarantee the delivery date. Most packages are delivered 1-3 days after being shipped. Please contact us if you package is not delivered 5 days after being shipped.

If you need your medication by a set date or wish to discuss our delivery options, please contact us.
There is a $16.50 shipping charge for packages shipping to another state.*

I approve the $16.50 shipping charge.I do NOT approve the $16.50 shipping charge
In order to account for documentation and time, we have implemented a $15 Processing Charge.*

I approve the processing charge(s) and understand my invoice will need to be paid before the prescription(s) will be processed.I do NOT approve the processing charge
You have declined the processing charge

Please select a different option for "Preferred Delivery Method"
Has your address changed since your last appointment?*

YesNo
Name of Preferred Pharmacy*
Ex: HEB - Elgin
Phone Number for Preferred Pharmacy*
Ex: 512-575-3231
Updated address or address requested for medication shipment *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
We require 72 hours notice (NOT including weekends) for pick up requests. If the Date/Time of your preferred pick up is less than 72 hours away, or if it falls on a holiday that we will be closed, this calendar will not allow you to select it. Please call or text us if your request is urgent, or select a different method of delivery.
Requested Pick Up Date*
We require 72 hours notice prior to your appointment for medication requests. If the Date/Time of your appointment is less than 72 hours away, this calendar will not allow you to select it. Please call or text us if your request is urgent or select a different method of delivery.
Date of Appointment*
Additional Notes
Should be Empty:

Refill Request

You have declined the processing charge