Medication Refill Request

MEDICATION REFILL FORM

Refill requests can take up to 2 business for review and processing. We will be in contact with you soon regarding your request. Thank you.
Please feel free to use the NAVIGATION TABS above or click through the pages to request everything you need.
Medications Not Available for Refills Without An Exam:

Antibiotics such as Ofloxacin, Tobramycin, Terramycin, NeoPolyGram or NeoPolyBacitracin

Single-course Healing Products such as Fresh Frozen Plasma, Serum or Optixcare EMS

Pain Medications such as Gabapentin, Tramadol, or Buprenex/Buprenorphine

Single-course Antivirals such as Cidofovir/Cidofadrops

**Please refer to your last Medication Sheet to see if your pet's medications were meant to be refilled. It will be written in PURPLE.**
OVER THE COUNTER & NON-PRESCRIPTION MEDS:
- Vizoovet Plus Eye Lubricant Drops OR Mist with Hyaluron (HA): WWW.VIZOOVET.US
- Can-C Cataract Eye Drops: WWW.WISECHOICEMEDICINE.COM/PRODUCT/CAN-C-IS-FOR-DOGS-TOO/
- Sodium Chloride Drops and Ointments (brand name is Muro 128)
- Artificial Tears Ointment (ex. GenTeal Night-Time Ointment)
- Artificial Tears Gel Drops (ex. GenTeal Severe Gel Drops, Refresh Celluvisc Eye Gel, etc.)
- Saline Eye Rinse
- Ketotifen Drops (brand names are Zaditor and Alaway)
- Optixcare Gel Lube 'PLUS' - can be purchased online
- Optixcare Eye Health - can be purchased online
- I-Drop Vet Gel or Plus - can be purchased online

Pick Up My Pet's Medications from Local Human Pharmacy
- OPTIMMUNE OINTMENT is an animal-only medication. Call the pharmacy first to see if they can order it for you BEFORE requesting a prescription to avoid delays. (Costco and Walmart typically can.)
- Also, Dr. Park is making a general recommendation to switch from Ketorolac to Diclofenac drops. If your pet is not experiencing a sensitive stomach or has had reactions to Diclofenac, you can continue using Ketorolac.
Please feel free to contact us if you have any questions. We're here to help!
What is the Name of your pharmacy?
Example: CVS, Target, Walgreens, etc.
Pharmacy Phone Number
The medications listed below are the only ones that can be called into a HUMAN pharmacy.
If you did not find what you needed, go to the next page to request a prescription to Chewy.com or another outside pharmacy.

Otherwise, if you're all done just click through to the end of use the Navigation Tab at the top of the screen to navigate to the last page.

SHIP FROM STOKES (i.e. EPICUR PHARMA), CLICK HERE...
Products from Stokes Pharmacy most often have a shelf life of about 6 months to 1 year from the manufactured date.

Chewy is a third-party distributor for Epicur Pharma so their "compounded" medications come from this pharmacy.

**Per Dr. Park-Dorner's authorization, we are switching all prescriptions of Cyclosporine/Tacrolimus 2%/0.03% to the 2%/0.02% version due to the ongoing backorder of the former.

SHIP FROM CHEWY.COM, CLICK HERE...
What is the email associated with your Chewy.com account?
example@example.com
What is the phone number associated with your Chewy.com account?
Compounded Medications Available through Chewy.com

Cyclosporine, Demecarium Bromide, EDTA, Pilocarpine, Tacrolimus
**Per Dr. Park-Dorner's authorization, we are switching all prescriptions for Cyclosporine/Tacrolimus 2%/0.03% to the 2%/0.02% version due to the ongoing backorder of the former.
Commercially Available Medications through Chewy.com

Dexamethasone, Dorzolamide, Ketorolac, Latanoprost, Optimmune, Pred Acetate, Sodium Chloride, Timolol, and more...
*Diclofenac is not available for shipment through Chewy.com. If you need it shipped, please find another online pharmacy to order directly from and we will review the authorization request that they send us.

OTHER ONLINE PHARMACIES THAT SHIP
For other ONLINE PHARMACIES, such as Allivet Pharmacy, VetRxDirect, 1-800-PETMEDS, etc., we recommend ordering directly through their websites to avoid any delays.

These pharmacies can ship medications to you such as Diclofenac, Ketorolac, Latanoprost, Optimmune, and many more...

Need Standard Process Products?

Eyeplex, Oculotrophin, Neurotrophin, Cyruta, Canine or Feline Immune Support, etc.
CLICK HERE TO REQUEST ACCESS TO STANDARD PROCESS FOR ORDERING.

Requesting access for ordering.
Okay! We'll email you a link and code to create your Standard Process - Patient Direct online profile, allowing you to order freely without further approval. Watch for our email after clicking Submit!

Need Chinese Herbals?

Facial P Formula, Max's Formula, Qi Ju Di Huang, Liver Happy, Haliotis, Wind Toxin, etc.
CLICK HERE TO REQUEST A PRESCRIPTION FOR CHINESE HERBALS FROM JING TANG HERBALS.

Requesting prescriptions for Chinese Herbals.
Okay! We'll review Dr. Park's recommendations and send prescriptions for all that was recommended, to you and the pharmacy if approved. Keep an eye on your email for our follow up!

READY TO SEND THIS TO OUR PHARMACY TEAM?
Did you find everything you were looking for? Remember, you can choose multiple options on this form.

Yes, I'm ready to send this to your pharmacy team.No, I did not.
Please write the name of the medication(s) you cannot find in the box below and we will see how we can help:
Name of Primary Pet Parent on the Account*

First NameLast Name
Pet's Name*
Want us to text you too?*

Just email me.Yes, text me too.
Confirm Your Email Address:*
example@example.com
REMEMBER: You can select everything you need on this form, including all the different ways of getting all the meds or prescriptions you need - no need to resbumit multiple times for different ways of getting things.

If you're all done, click Submit. Our pharmacy team will be in touch with you as soon as possible! Have a great day!
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MEDICATION REFILL FORM