Moffett Road Veterinary Clinic

Prescription Refills

Moffett Road Veterinary Clinic is proud to offer a wide variety of all the latest veterinary products and medications for your pet. This includes, but not limited to, heartworm and flea preventions, deworming products, shampoos and veterinary diets, and a full line of therapeutic medications for your pet's needs. We think you will find that our prices are competitive with online pet pharmacies, but most importantly, when purchased from us, you are getting peace of mind that the products are safe and recommended by our veterinarians.

To use our online prescription refill service, your pet must be a current patient with us and in most cases must have been seen for an examination within the past 12 months. Certain cases will require your pet to be examined within 6 months, and some medications can not be refilled without a current blood test to monitor the level of the drug or to check for potential harmful side effects from the medication. We will contact you at the number you provide on this form if we are unable to process your request in the event your pet needs a current exam or bloodwork. We appreciate your understanding on this matter as we want to provide the safest and best health care for your pet.

Please allow 24 hours to process your request during weekdays and 48 hours over the weekend.

Please also specify if you would like us to ship to you or if you will pick up at the office. If you want the product shipped to you, we will contact you at the number you provide to obtain your credit card information. There will be no charge for shipping. We regret that we are unable to ship large items such as dog food.

Prescription Refill and Product Request Form:

Items marked with * are required. Please complete one form per pet and enter the phone number where you can be reached. For items to be shipped to you, please have a credit card available when we call. Thank you!

* Pet's Name:
* Owner's Last Name
(as it appears on the account):
* Owner's First Name
(as it appears on the account):
* Street Address:
* City:
* State:
* Zip:
* Phone Number
(in the event we need to contact you):
Email:
* Medication or Product to be refilled:
* Dosage: mg, size, weight, etc.
* Quantity
(number of pills, capsules, pkgs. etc):
(Note: For packaged products, write the package size
such as.Sentinel 51-100 lbs 6 month supply.)
* Delivery Method: Pick-up at the office Mail to me
Comments or Questions:

Validation Number:
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