Please fill out ALL information on this form and we will contact you regarding your prescription refills. If you are not sure about the spelling of a medication, type it in the best you can. We will call if we have questions, so please provide a daytime phone number where we may contact you. Please don’t forget to type in the word verification letters and numbers as shown. Without this security verification, your request will not come through to us. Please allow 24 hours for your request to be filled, so please don’t wait until your pet has run out of his or her medications!