Rx REFILL REQUEST

Need a pet's prescription refilled? No problem! Fill out this form with the medication(s) that you would like to refill for your pet.

If you use our online form: Please allow us 24 hours for your prescription request to be reviewed, filled and available for pick-up. If for some reason the prescription cannot be refilled, someone from our staff will contact you.

 

Need it a bit quicker? Feel free to call the clinic with any refill requests.

 

If you are calling in a refill, please note:

If your request is called in before 10AM your refill will be ready to pick up by 4pm the ame day. 

If your request is called in after 10AM your refill will be ready for pick up by 10AM the next business day.

Rx REFILL FORM
Client and Patient Information
Prescription Information

Medication

Dosage & Strength

Qty

Comments
Please Note:

By clicking the "Submit" button below, you are agreeing that your pet is a current patient, and are authorizing Tillema Veterinary Clinic to review your pet’s medical records and refill any medication requested in the form above. Should your pet need a physical exam or bloodwork before refilling any medication, a staff member will contact you. If you would like a quote before refilling any medication, please give us a call at 951-547-1675.