Prescription Refill Request

In order to refill your prescriptions, please provide the following information.

Please be advised that all medications require 48 hours (2 business days) to refill.

Should you require this refill sooner, please call the office directly at 613-531-3334 during our business hours.

Owner's Full Name *

Phone Number *

Email Address *

Pet's Name *

Pet's Species *

Name of Medication *

Current Dose *

Requested Refill Quantity *

Approximately how many days of medication do you have left? *

How would you like to be contacted once the medication is ready? *

Email
Call
Text

Location

Security Question *

I HAVE READ AND UNDERSTOOD THE PRIVACY POLICY *

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