Rx Refill

Your Name

First NameLast Name

Your Phone Number

Please enter a valid phone number.

Is this medication refill being paid by a rescue?

Pet's Name (the name CHEW has on file)

Rescue's Name

What Medication are you wanting refilled? -- include mg

Example: Carprofen, 25mg

What are the dosage instructions?

Example: Give twice a day

Are you following the current dosage instructions?

Please explain what you are giving this patient. How often? How much?

How soon do you need this medication?

How many would you like filled?

Any concerns about your pet using this medication?

Has your pet been seen at CHEW in the past 12 months?

Thank you for filling out our Rx form, we will process your refill as soon as possible!

Please take a moment to read the following important information:

▪️ Support our pharmacy at CHEW Animal Clinic and make a difference.

▪️ Why is this important?

🦋 When we purchase larger quantities of medication, pharmaceutical companies provide us with discounts. By filling your prescription at our pharmacy, we can continue benefiting from these discounts.

🐝 While we strive to keep medication prices low, we also generate a small profit to sustain our operations. Our services alone do not cover our costs, and any additional revenue helps us further our mission.

🐞 Orders over $50, a flat $5 shipping charge

🐜 For all other medications, we offer a flat shipping fee of $8.00.

🪲 If you reside in the Dallas area and prefer not to have it shipped, we kindly encourage you to consider picking up your medication at CHEW.

Will you be picking up this medication?

Please fill out your shipping information

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

***If you are buying prevention (Simparica Trio, Heartgard, Senergy, Bravecto) how many month prevention are you wanting?

CHEW Rx Refill Request