Cape Ann Veterinary Hospital

Prescription Refill Request

Step 1:  Submit the following form. 
            In the Medication requested field, please include
                     - the exact drug name as it appears on label
                     - the pill strength in mg (or concentration of liquid in mg/mL)
                     - the quantity of pills or liquid you are requesting for the refill
                     - how much medication (and how often) you are giving the drug to your pet

               *** You may pay for the refill when you pick it up. If you would like to pay in
                       advance, please include a valid credit card number in the Additional 
                       Comments field (including exp date, security code and billing address).  
                       Please include a mailing address if you would like us to mail you the refill.

Step 2:  Your refill request will be filled after it is approved by one of our veterinarians

Step 3:  We will contact you within one business day to let you know your prescription is ready

Form - Prescription Refills Online

Name (required)
First Name (required)
Last Name (required)
Address
Street Address
City
State/Province
Zip/Postal Code
,
E-Mail Address (required) :
Daytime Phone (required)
Phone TypePhone Number (required)
Evening Phone (required)
Phone TypePhone Number (required)
Pet's Name (required)

Sex
Male
Female

Age: Years, Months

Have we seen your pet within the last year?
Yes
No

Additional Comments / Questions

Medication Requested (required)


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