Repeat Prescription Request Form

If you have already been prescribed items for your pet and need to order repeat quantities of the same items please complete the form below. Please note that it is essential for the wellbeing of pets on long term medication that their condition is assessed and medication reviewed by a vet on a regular basis, usually at 3-6 monthly intervals.
All fields with an * are required.
  1. Title*
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  2. Forename*
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  3. Surname*
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  4. Name of pet*
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  5. Email address*
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  6. Address line 1*
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  7. Address line 2
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  8. Town*
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  9. Postcode*
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  10. Phone*
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  11. MobileThis makes it easier to contact you if we have a query with your prescription request.
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  12. Select Surgery for Collection*
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  13. Prescriptions will usually be available for collection 24 hours after requests are received. Prescription requests submitted between Thursday 5.00 pm and Sunday 12 noon will usually be available for collection from noon the following Monday (excluding Bank Holidays).
  14. Current Medication Pack or Bottle Size
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    2 Invalid Input Invalid Input
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  15. *Invalid Input
  16. *Invalid Input
  17. Are you human?*
    Are you human?
    Please enter the letters from the image above.