Medication refill request form The Pet Hospitals

Please note, this form is for refills of your pet's existing medications only.
Do NOT use this form for heartworm or flea prevention (Simparica Trio, Advantage Multi, Bravecto or Revolution). If we have seen your pet within the last year, please just stop by during normal business hours.

Owner's first and last name

Phone number on your account

Owner's email

Pet's name

Medication name

Do you need to request more than one medication for the above pet?

YesNo

Medication name

Do you need to request medication for another patient?

YesNo

Pet's name

Medication name

What location would you like to pick your meds up at?

How would you like to be contacted when its ready?

If I have previously opted out of text messages before, The Pet Hospitals has my permission to opt me back in today

YesNo

Phone number for the phone call when ready

Phone number for text message when ready

Please note our hours below
Monday - Friday 7am until 6pm All locations
Saturday & Sunday 8am-2pm at our Collierville, Lakeland, Poplar & Downtown locations only

Please note if you are filling this out on a Saturday or Sunday it will not be read until Monday. If this is a time sensitive medication request please call or request the refill via chat on our website.

I understand

If you need heartworm or flea prevention and we have seen your pet within the last year, you do not have to use this form or call us. Please just stop by during normal business hours.

Contact Information