Prescription Refill Request Form
For use by established patients and their owners. Pet must have an active Veterinarian-Client-Patient-Relationship (VCPR) with Home Vet Care. A VCPR is established when your veterinarian has the opportunity to examine your animal in person and continues only as long as regular visits with your veterinarian are maintained, at a minimum every 6-12 months or whenever your pet's medical condition changes.
Refills for instock medications are usually available for pick up within 24 hours. Special order medications may require up to 7 days for arrival.
Patient's (pet's) name:
Pick Up Options:
Mail directly to address on file for a $10 fee.
Pick up at Home Vet Care home office. Instructions will be sent in invoice email.
What medication(s) would you like refilled?
Amount you would like refilled?
Same amount as last time
Maximum amount possible (usually 2-3 months)
Will pay by check (preferred)
Please send me a link to pay online
Anything else you'd like us to know?
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service