Important Information: Please Read First!

  • Your pet must have been examined by the prescribing veterinarian within the past year. If not, you must make an appointment for an exam to continue any medication
  • Requests are checked at 8:00AM and 1:00PM. We will call you as soon as they are ready to be shipped or picked up.
  • If medications are to be shipped, payment must be made before shipping. We will call you for your information. Shipping cost is $5.00
  • If medications are to be picked up, payment is due at time of pickup.
We are sorry for any inconvenience and appreciate your cooperation. Thank you.

Form - Prescriptions Refill

Name (required)
First Name (required)
Last Name (required)
Address (required)
Street Address (required)
City (required)
State/Province (required)
Zip/Postal Code (required)
,
Day Time Phone
Phone TypePhone Number
Evening Phone (required)
Phone TypePhone Number (required)
E-Mail Address :
Pet Information
Name (required)

Have we seen your pet within the last year? (required)
Yes
No

Prescription Information
Name of Medication (required)

Dosage of Medication (required)

Quantity (required)

Additional Information
Questions & Comments

Would you like this prescription shipped to you? ($5 Shipping Charge) (required)
Yes, please ship this to my address above at an additional $5 shipping charge
No, I will pick this up (No shipping charges apply)


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