Prescription Refill Request Form

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 immediately please call our office to request your prescription.

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

Client Information

Owner's First Name *

Owner's Last Name *

Street Address *

City *

State / Province *

Zip / Postal Code *

Email Address *

Daytime Phone *

Daytime Phone Type *

Evening Phone *

Evening Phone Type

Patient Information

Pet's Name *

Have we seen your pet within the last year? *

Yes

Has your pet previously been on this medication? *

Yes

Medication Requested *

How is medication currently being given? *

How is your pet doing on the medication?

Additional Comments/Questions/Considerations

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Monday:08:30 am - 06:00 pm
Tuesday:08:30 am - 06:00 pm
Wednesday:08:30 am - 06:00 pm
Thursday:08:30 am - 06:00 pm
Friday:08:30 am - 05:30 pm
Saturday:Closed
Sunday:Closed

Prescription Refills

Prescription Refill Request Form

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