Repeat prescription request

Name

Address

Telephone (essential in case of any queries)

Pet's Name

Medication (First) (including size of tablet if possible)

Dose (First) (that you are currently using)

Quantity (First) (medication requested)

Medication (Second) (including size of tablet if possible)

Dose (Second) (that you are currently using)

Quantity (Second) (medication requested)

Medication (Third) (including size of tablet if possible)

Dose (Third) (that you are currently using)

Quantity (Third) (medication requested)

Medication (Fourth) (including size of tablet if possible)

Dose (Fourth) (that you are currently using)

Quantity (Fourth) (medication requested)

Comments

Collect from




Use this form to order repeat prescriptions for your pet. Please allow 2 working days for processing of the prescription. Your prescription will then be available at the surgery for uplift. Please state which surgery you wish to collect from.

Only use this form if you are happy with your pet’s progress, and wish to stay on the same medication.

If you have any concerns regarding the health of your pet, or think that a change of medication may be required, please phone the surgery to discuss with a vet.