Prescription Refill Request

Please allow 24 to 48 hours for refill requests to be processed. For urgent requests please contact our office at 716-852-8276 to expedite pick up.

Owner's Name*

Owner's Email Address*

Phone Number Where You Can Be Reached*

Pet's Name*

Prescription Information:

Today's Date*

Requested Pick-Up Day
MondayTuesdayWednesdayThursdayFridaySaturday

Requested Pick-Up Time
MorningAfternoon