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 an examination of your pet prior to re-filling. Many prescriptions 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 pet’s current condition. IMPORTANT: Prescription Refill Requests are not confirmed until you have received notification. A staff member will contact you by phone, text or email.
Cell Phone Number
Home Phone Number
Preferred Communication Choice
My Pet's Weight is based on:
Same as last visit
I weighed my pet on a home scale
Dosage or Strength:
How many months coverage are you requesting?
Additional Information: Please list additional medications you would like refilled. Include the name of the medication and how many months you require.
Should be Empty: