Prescription Refill Requests

All prescription refill requests must be approved by a veterinarian before being refilled.

New prescriptions and refills require a physical exam for the patient requesting the refill at The Animal Hospital of Carrboro within the last 365 days.

 

This request is for prescriptions that will be filled and picked up at The Animal Hospital.

 

Your Information

Your Name: (required)

Your Email :(required)

Phone: (required)

Pet´s Name: (required)

Doctor´s Name: (required)

Prescription 1

Prescription 1. Drug Name:

Prescription 1. Strength

Prescription 1. Quantity

Prescription 1. Date requested for pickup:

Prescription 1. Time requested for pickup: (hr:min)

Prescription 2

Prescription 2. Drug Name:

Prescription 2. Strength

Prescription 2. Quantity

Prescription 2. Date requested for pickup:

Prescription 2. Time requested for pickup: (hr:min)

Prescription 3

Prescription 3. Drug Name:

Prescription 3. Strength

Prescription 3. Quantity

Prescription 3. Date requested for pickup:

Prescription 3. Time requested for pickup: (hr:min)

Additional Information

Message (required):