Heartworm Prescription Refill Request

Your Name*

First NameLast Name

Pet's Name*

Please note the following:

1. Heartworm Preventative can only be refilled with a current exam and current heartworm test and may take up to 72 business hours for approval. A rush fee may be applied if the preventative is needed sooner.

2. If your pet has missed more than 2 doses (more than 60 days without prevention) but not more than 6 doses (6 months) you may restart heartworm prevention without testing. If your pet has missed more than 6 months of preventative a heartworm test is required prior to restarting to ensure they are not positive. In addition to their annual testing, if there has been a gap in treatment of more than 60 days we recommend performing a heartworm test 6 months after restarting to ensure your dog is not positive.

3. Please note that we do not work directly with online pharmacies. Some, like Chewy, now require a hard copy of the written prescription to be mailed directly to them. We will always prepare a written prescription for you to pick up upon request.

Simparica Trio 12 month supplySimparica Trio 6 month supplySimparica Trio single doseOther

NoYes

Pearl Animal HospitalVetSource (PAH Online Pharmacy)Written Prescription (required for all pharmacies other than PAH or PAH Online Pharmacy)Other

A staff member will be in touch if there are any follow up questions. Please remember that it can take up to 72 business hours to process your refill request.

Once the heartworm preventative is filled we will contact you to let you know it is ready to pick up.

If the heartworm prevenative or written prescription is not picked up within 2 weeks of the filled date, it will be returned to stock and will need to be re-requested.