To make your pet’s health care as convenient and easy as possible, you can now request a refill for your pet’s prescription by submitting the form below. The prescription refill must be approved by a doctor, so it’s important that you provide all the requested information when you complete the form.

We will notify you via email or phone when your pet’s prescription is approved and ready to be picked up. We will also inform you of the total cost of the prescription, and will request a credit card number by phone at that time. If you would prefer to have the prescription mailed to you, please let us know in the “additional comments” area of the form.

Please note, requests including controlled substances may require additional time allotted.

Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Daytime Phone
Phone Type
Evening Phone*
Phone Type
Pet's Name*
Sex
- Male
- Female
Age: Years, Months
Have we seen your pet within the last year?
- Yes
- No
Medication Requested*
Medication Quantity Needed*
Current Dosage*
Additional Comments / Questions