Prescription Refill Request Form Refill Request Form Pet Owner's Name * Pet Owner's Name First First Last Last Phone Number * Email * We advise that you keep 2-4 weeks extra of food and prescriptions on hand at home as unexpected backorders or nationwide shipping issues can sometimes cause delays that lead to interruptions in your pet’s care. How would you like to get your refill? * Ship To My Home - Purina ProPlan Ship To My Home - Medications, Supplements, Foods other than Purina Pick Up Refill At Healing Paws Pick Up Written Prescription To Use At Pharmacy of My Choice No Preference Click Here to Order Purina Products Shipped To Your Home Please use code 9HDXZ at check out. Shop with Us Patient Name * List the first product you need refilled (one product only, you will have the ability to list others later in this form). * How much are you giving your pet and how many times a day? * We recommend always having 2-4 weeks extra of long term prescriptions on hand, how much of this product would you like to order? * One-month supply (if available) Three-month supply (if available) Six-month supply (if available) OtherOther Do you need other products refilled for this pet? * Yes No If others, please name the product/s in detail. How much are you giving your pet and how many times a day? * We recommend always having 2-4 weeks extra of long term prescriptions on hand, how much of this product would you like to order? * One-month supply (if available) Three-month supply (if available) Six-month supply (if available) OtherOther How is your pet doing on these medications or food (same, better, worse, etc.)? * Are you having any trouble getting your pet to take these medications or food? * If so, our team will evaluate if there are better options to help make things easier. Within what time frame will you run out of the food, medication, or product? * Our doctor and staff that fills prescriptions is also the team that cares for patients and sees appointments, prescription refills, and written prescriptions have a five business day processing time. If you need your refill more urgently and have told us so above, we will do our best to meet your needs but may not be able to get the product for you earlier d ending on stock and staffing levels. Due to nationwide stocking shortages and shipping delays, we also recommend that you always keep 2-4 weeks extra of food and prescriptions on hand at your home. Thank you. Please visit our Healing Paws Veterinary Care Online Store, which is linked directly to your pet's medical records, allowing us to ship products to your home straight from our distributor without the need for you to come to the clinic to pick up a written prescription. Our online store products allow you to support us as a locally owned small business, trust that the products you receive are accurate, and order easily at any time, day or night and because it goes straight to you from the distributor, the cost is less than picking up products at our clinic. Most big box online pharmacies are now requiring "wet signature" written prescriptions. These prescriptions take five business days for us to process and require you to pick up the prescription in person from Healing Paws, and then you must post-mail the prescription to the online pharmacy you have chosen. Our Healing Paws Veterinary Care Online Store skips these steps completely. Please remember, if choosing an online pharmacy other than our direct distributor, you should always follow these FDA Choosing an Online Pharmacy Safety Recommendations. Please choose one of the following options: * I would like to quickly order now from the Healing Paws Veterinary Care Online Store I have not used the Healing Paws Veterinary Care Online store before, I would like a team member to review the products I need and send me the online store link with a 10% coupon! I have read the above and decline the 10% coupon. I understand the above and release Healing Paws Veterinary Care and its employees from any responsibility regarding the safety and accuracy of products I purchase for my pet through third party online pharmacies. I understand that a written prescription takes 5 business days to process and I am responsible for picking up that written prescription and submitting it to the pharmacy of my choice. Click here to visit our online pharmacy! Patient Name * List the first product you need refilled (one product only, you will have the ability to list others later in this form). * How much are you giving your pet and how many times a day? * We recommend always having 2-4 weeks extra of long term prescriptions on hand, how much of this product would you like to order? * One-month supply (if available) Three-month supply (if available) Six-month supply (if available) OtherOther Do you need other products refilled for this pet? * Yes No If others, please name the product/s in detail. * How much are you giving your pet and how many times a day? * We recommend always having 2-4 weeks extra of long term prescriptions on hand, how much of this product would you like to order? * One-month supply (if available) Three-month supply (if available) Six-month supply (if available) OtherOther How is your pet doing on these medications or food (same, better, worse, etc.)? * Are you having any trouble getting your pet to take these medications or food? * If so, our team will evaluate if there are better options to help make things easier. Within what time frame will you run out of the food, medication, or product? * Our doctor and staff that fills prescriptions is also the team that cares for patients and sees appointments, prescription refills, and written prescriptions have a five business day processing time. If you need your refill more urgently and have told us so above, we will do our best to meet your needs but may not be able to get the product for you earlier d ending on stock and staffing levels. Due to nationwide stocking shortages and shipping delays, we also recommend that you always keep 2-4 weeks extra of food and prescriptions on hand at your home. Thank you. Patient Name * List the first product you need refilled (one product only, you will have the ability to list others later in this form). * How much are you giving your pet and how many times a day? * We recommend always having 2-4 weeks extra of long term prescriptions on hand, how much of this product would you like to order? * One-month supply (if available) Three-month supply (if available) Six-month supply (if available) OtherOther Do you need other products refilled for this pet? * Yes No If others, please name the product/s in detail. * How much are you giving your pet and how many times a day? * We recommend always having 2-4 weeks extra of long term prescriptions on hand, how much of this product would you like to order? * One-month supply (if available) Three-month supply (if available) Six-month supply (if available) OtherOther How is your pet doing on these medications or food (same, better, worse, etc.)? * Are you having any trouble getting your pet to take these medications or food? * If so, our team will evaluate if there are better options to help make things easier. Within what time frame will you run out of the food, medication, or product? * reCAPTCHA Submit If you are human, leave this field blank.
