Prescription Refill Request Form

Please use the form below or go to your Pet Portal to request your prescription refill item(s). These will save you time when picking up your order. Please allow at least 48 hours for order processing. Do not come to the clinic until you have received confirmation to pick up your order.

If you are concerned that you will run out of medications before hearing back PLEASE CALL US instead of using this form or the Pet Portal.

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

First Name:

Last Name:

Email:

Phone:

Pet Name:

Drug or Food Name:

Dosage/Size/Strength:

The number of doses left in the current prescription:

Additional Comments: