Prescription Refill Request Form

Prescription Refill Request Form

Please use the form below to request your prescription refill. This will save you time when picking up your order.

Please allow 1-2 business days for order processing. Do not come to the clinic until you have received confirmation to pick up your order.

NOTE: Some prescriptions will require your pet to be examined before dispensing. This ensures that your pet is healthy enough to handle the potential side effects of some prescriptions and provides further confirmation that the medication is appropriate for your pets' current condition:

IMPORTANT: Prescription Refills are not confirmed until you have received notification. A staff member will contact you by phone, text or email.

*Please note: If your prescription is URGENT (ie. your pets' health will be seriously compromised by missing doses) PLEASE CALL THE CLINIC TO PLACE YOUR PRESCRIPTION REQUEST AT 250-832-6069.

Full Name*

First NameLast Name

E-mail*

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Please allow 1-2 business days for your request to be processed. Business hours are between 8:00am-5:00pm Monday- Saturday with a 1 hour closure between 12:00pm-1:00pm on Saturdays.*

I have read and acknowledge this information.

You will get a notification via phone, text or email once your order is confirmed. Please do not come to pick up your prescription until you have been contacted by a staff member.*

I have read and acknowledge this information.

Preferred Communication Choice*

TextPhoneEmail

Pet's Name*

Pet's weight:*

My Pet's Weight is based on:*

Same as last visitI weighed my pet on a home scaleGuesstimate

Medication Name:*

Dosage or Strength:*

How many months coverage are you requesting?*

1 month2 months3 monthsOther

Additional Information: Please list additional medications you would like refilled. Include the name of the medication and how many months you require.

Your request is not confirmed until you receive notification from our team. Thank you for your understanding and co-operation.

Pet Details