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Your contact information: First Name:  * required Last Name:  * required Pet's Name:  * required Email address:  * required Phone number:  * required Prescription Information     Medication Requested Dosage Size / Strength Quantity Requested Name: Name: Name: Name: Name: Would you like prescription mailed to you?: No Yes Please provide a phone we can reach you at if we have a question regarding your request. Comments/Questions:   Federal and State laws, as well as good medical practice, prohibit us from dispensing prescription medications without prior examination of your animal (within the last 12 months), and current knowledge of your animal's health. We are similarly prohibited from dispensing or refilling medications that were originally ordered by another veterinarian. We will be happy to dispense any needed medications after examining your pet.