Prescription Refill Request Prescription Refill Request Form Patient's Name * Name * Name First First Last Last Email * Medication * Dosage * Quantity * Request a written script for pick-up I request a written script for pick-up Disclaimer: This prescription request is only for refills without any changes from your pet’s prior prescription. All requests need to be approved by our veterinarians before dispensed. New prescriptions will require a call to our office and, in most cases, a visit to your veterinarian. This prescription refill service will be checked twice per day (Monday through Friday). Requests received over weekends or holidays will be processed on the next business day. Please allow 72 business hours for your request to be processed. Be sure to complete all information on the form to ensure proper service. Please call the practice before picking up your prescription to ensure that the request has been filled. Please be aware that if you leave a prescription refill request for a controlled substance the prescription CANNOT be called in to the pharmacy. If approved, it will be a written prescription and will be available for pick up after 72 hours. This time period allows the veterinarian’s time to review your pet’s chart to ensure that all is in order for the refill. Captcha Submit If you are human, leave this field blank.
