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Prescription Refill and Food Order Request Form
Please use the form below to request your prescription refill or food item. This will save you time when picking up your order. Please allow 6 hours for order processing. Do not come to the clinic until you have received confirmation to pick up your order. We will be contacting you by phone or email. Note: Some prescriptions will require an examination of your pet and/or blood work prior to re-filling. This ensures that your pet is healthy enough to handle the potential side effects of some prescriptions and provides further confirmation that the medication is appropriate for your pet’s current condition.
Name
*
First
Last
Email
*
Phone
*
Pet Name
*
Medication or Food Name
*
Dosage/Size/Strength
*
Quantity
*
Additional Comments (please let us know how your pet is doing on his/her current medicaiton or food)
*
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