Ridgemont Animal Hospital

4200 West Ridge Road
Rochester, NY 14626

(585)225-2133

ridgemontanimalhospital.com

Prescription Refill Request

In an effort to make your pet's health care convenient and easy, you can now request your pet's prescription by submitting the on-line refill request form.  Please be sure to fill in all the required fields.  All prescriptions must be approved by the doctor.  We will notify you by email or phone after your pet's record has been reviewed and a decision has been made regarding the refill status of your pet's prescription. 

Please allow at least 3 business days for a reply. If you need your pet's medication refilled prior to that please call our office personally. 

We are required by New York State law to have a current client/patient/veterinary relationship to fill or refill any prescriptions.


Prescription Refill Request

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

Have we seen your pet within the last year? (required)
yes
no


Has your pet previously been on this medication? (required)
yes
no


Medication Requested (required)

How is medication currently being given? (required)

How is your pet doing on the medication? (required)

Additional Comments/Questions/Considerations


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