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Prescription Refill Request
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RX REQUEST AT CLINIC
RX REQUEST AT CLINIC
RX REQUEST AT CLINIC
Client Account Name (& Contact Person if different)
*
Email
*
Phone
*
Pet Name
*
Prescription Information
Please confirm the following information from your current prescription bottle or previous invoice, if unsure please note in comments:
Name of Medication and Strength
*
How much are you giving per dose?
*
How often are you giving the medication?
*
Last four digits of the card number they would like to use:
*
When would you need to pick up the medication by?
*
MM slash DD slash YYYY
* We aim to refill medications promptly but please allow 1-2 business days from the time of request for unforeseen delays. * A team member will contact you when your prescription is ready. Arranging payment prior to the desired pick-up time will expedite the pickup process and shorten wait times.
Comments (changes in pet weight, questions and concerns about medications, etc)
*Please note that prescription medications may NOT be returned once dispensed per State and Federal Laws.
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Prescription Refill
What's Next
1
Call us or schedule an appointment online.
2
Meet with a doctor for an initial exam.
3
Put a plan together for your pet.
Make An Appointment