Pharmacy Request
Please be aware that completing this request form does not automatically mean your prescription will be processed - doctor approval is necessary and refill availability is subject to inventory. 

In certain cases, a veterinary appointment may also be needed. We will respond to your request with either approval or denial of the refill, along with an estimated pick-up time.

IndianHillsVet@gmail.com
256-214-3006 | IndianHillsEquine.com
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Email *
First & Last Name *
Phone Number for Text Verification *
Patient Name *
Medication  *
Formulation *
Current Dosage
Delivery Instructions *
Auto Delivery?  *
Required
Address for Shipping
Payment Options *
Questions related to this request:
A copy of your responses will be emailed to the address you provided.
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