Prescription Refill Request Form

These forms are to be filled out and submitted by current clients only as we need to have a relationship with you and your pet in order to prescribe any medication or prescription diets. If your pet is not currently a patient at Nelson, please contact us at 905-336-2800 so we can assist you further.

Please fill out all the required fields in the appropriate form below to ensure we have all the correct information to refill your pet's medication.

Please allow for 72 hours for all refills and orders to be received and ready for pick up. If you need medication sooner, please call us directly.

You will be contacted once medications are filled or if we have additonal questions about the refill.

Your Name

First Name

Last Name

Pet's Name

Phone #

Medication name

Located on your previous prescription label

Strength of Medication

You can find this in the bottom right hand side of the label. Listed after medication name. (mg or mg/ml)

Quantity you would like refilled

(mls/tablets/capsules)

Amount being given at each dose

how many mls/tablets or capsules are given at each dose?

How often is the medication being given?

Once per day

Twice per day

Every other day

Other, if so please mention is comments below

Please let us know how your pet is doing!

Comments