Repeat Prescriptions

Clients: Please use the form below to request repeat prescriptions for your animal. Please allow at least 2 working days notice so that your request can be authorised by a veterinary surgeon.

If you require medications for more than one pet, please submit a separate request for each animal.

We are required by law to check each patient every 3 - 6 months, so that we can continue to prescribe prescription medication. We will be unable to dispense any further medication should you fail to return for a re-examination.

Repeat Prescription form

Your details

Are you a registered client?

Has your pet been examined by our vets within the last 3 months?

Title

e.g. Ms / Miss / Mrs / Mr

First name

Last name

Address

Town

County

Postcode

Home telephone

Work telephone

Mobile

Pet details

Pets name

Prescription required

1. Medicine name

Size

(e.g. 25mg or 10ml bottle)

Quantity required

Current dose

2. Medicine name

Size

(e.g. 25mg or 10ml bottle)

Quantity required

Current dose

3. Medicine name

Size

(e.g. 25mg or 10ml bottle)

Quantity required

Current dose

4. Medicine name

Size

(e.g. 25mg or 10ml bottle)

Quantity required

Current dose

Comments