VetSource Home Delivery ButtonNew Prescription Requests

We've partnered with VetSource to bring you the convenience of ordering pet health products online with direct delivery right to your door. (Click button at right to access our Online Pet Store.)

Refill Existing Prescriptions

To refill an existing prescription, please fill out and submit the form below. If you do not hear from us within one business day after submitting your request, give us a call us at 716-681-3033.

* Denotes required field.

Client Information:

* First Name:
* Last Name:
* Primary Telephone Number:
* Email Address:

Pet Information:

* Pet's Name:

 
* Species:

e.g. canine, feline, etc.
Age:
Breed:

Rx Information:

* Medication or Diet:

e.g. deramaxx
Strength:

e.g. 100mg
Dosage/Directions for use:

e.g. 1/2 tablet every 12 hours
* Quantity:

e.g. 30 tablets

Pickup Information:

* Date for Pickup:

e.g. Thurs July 20
Time of the Day:

e.g. after 12pm