Prescription Refill Request- For Pick Up At Our Clinic

Prescription Refills: We understand your time is valuable. If possible, call ahead for refills or use the online form below to minimize your wait time at pick-up. * All prescriptions, including heartworm preventatives, require doctor review and approval and a current yearly physical by Maryland law. For the safety of your pet, certain medications require blood testing and checkups at regular intervals in order for your pet to continue on the medication. Please remember that our doctors have scheduled appointments and surgeries each day that deserve their full attention. Thank you!

*Prescription medications are regulated by the Federal Drug Administration (FDA) and veterinary practices are subject to the same dispensing laws and accountability as human pharmacies. Any prescription medication that has left the building, regardless of whether or not it has been opened, cannot be returned.

Prescription Refill Request

Please note that all prescription medications are federally regulated. Pets must have a current yearly physical exam for requests to be approved by doctor. For prescription changes or special requests, please call our office. This form allows up to two medications per pet (for now). When you have entered the required information, press Submit. We will receive the request via email and you will receive an automated confirmation. Thank you.

Owner's Name *

First

Last

Pet's Name *

Phone # *

Email (Optional)

Name of Medication *

Current Dosage Given (how many, how often) *

Is medication working at this dosage? Please explain problems. *

When do you need this refill? *

Within 48 hours
Today if possible
Urgent, need now, out of medication.

Would you like us to call you when prescription is ready for pickup? *

Yes, please
No, I'll pick up later today
No, I'll pick up later this week

Name of 2nd Medication

Current Dosage Given- 2nd Medication

Is medication working at this dosage? Please explain problems.

Name