Prescription Refill Request Form

Please fill out the form below in full to request your prescription refill. Prescription refills are for current clients only and are not confirmed until you have received notification.  A staff member will contact you by phone or email during the department’s regular business hours.

Emergency Refill Request

If this is an emergency request, please contact our office directly by calling (905) 829-9444. An emergency refill fee will apply for refills out of your department’s regular business hours.

Pharmacy hours: Monday to Friday – 8 am to 4 pm (excluding holidays).

First Name*

Last Name*

Email*

Phone*

Specialist's Name*

Department*

Pet Name*

Drug Name*

Dosage/Size/Strength*

Frequency*

Quantity*

Additional Comments

Verification Code (required)

Please answer math questions with single digits. Do not spell the number.