If this is an EMERGENCY, please call the hospital. Please allow 1-2 days for response. If you need medication faster than that, please call the hospital.

	First Name:
	Last Name:
	Pet's Name:
	Phone Number:
	email:

 

Prescription Request
Medication Requested		Dosage Size / Strength	Quantity Requested
Name:
Name:
Name:
Name:

If your pet is taking medication for a chronic problem,
please check the chart for special information or testing recommendations: Medication Chart.

Phone number we can reach you at if we have a problem filling your prescription:
Comments :

* The refill form is for the convenience of our clients that have previously been given a medication by one of our veterinarians. The prescribing veterinarian will review the request, and you will be contacted if it cannot be filled for some reason. An email confirmation will be sent for filled requests.

Federal and State laws, as well as good medical practice, prohibit us from dispensing prescription medications without prior examination of your animal (within the last 12 months), and current knowledge of your animal's health.

We are similarly prohibited from dispensing or refilling medications that were originally ordered by another veterinarian. We will be happy to dispense any needed medications after examining your pet.