medication refill request form

Please complete this form for all medication refill requests. Please note that this form can only be used for medications previously prescribed/dispensed at The Wild Vet.

Before completing this form, I acknowledge: *

Medication refill requests require 2–3 weekdays to process as each request must be individually reviewed and approved by a veterinarian.

Before completing this form, I acknowledge: (copy) *

Medication refills are not processed on weekends or public holidays.

Before completing this form, I acknowledge: (copy) *

My pet has been examined by a veterinarian at The Wild Vet within the last 6 months. I understand that medication can only be dispensed to last until the next required recheck.

Before completing this form, I acknowledge: (copy) (copy) *

If my pet has not been examined within the required time frame, a veterinary consultation will be required before medication can be dispensed

Before completing this form, I acknowledge: (copy) (copy) (copy) *

The final decision regarding medication supply, quantity dispensed, and prescription approval is at the discretion of the treating veterinarian.

Before completing this form, I acknowledge: (copy) *

Some medications are not routinely stocked and will require pre-payment before ordering.

Before completing this form, I acknowledge: (copy) (copy) *

Medications ordered to the clinic may take up to 1 week to arrive, potentially longer for compounded medications.

Before completing this form, I acknowledge: (copy) (copy) (copy) *

For medications sourced at an external pharmacy, we recommend allowing 1–2 weeks for standard medications, and 2–3 weeks for compounded medications, to avoid interruptions to your pet's treatment

Before completing this form, I acknowledge: (copy) (copy) (copy) (copy) *

I understand it is my responsibility to request medication refills before my pet runs out of medication.

Before completing this form, I acknowledge: (copy) (copy) (copy) (copy) (copy) *

If requesting a prescription to be sent to an external pharmacy, I understand dispensing times and medication availability are outside the control of The Wild Vet.

Owner First Name *

Owner Surname *

Owner Email Address *

Pet Name *

Species *

Requested medication(s) *

Current dosage and frequency *

Medication volume/duration of supply requested (at vet's discretion) *

Preferred method of medication supply

Pick up medication from The Wild Vet
Script sent to a human pharmacy
Script sent to an online pet pharmacy
Compounded medication ordered by The Wild Vet (may be collected from the clinic or posted directly to you)
Compounded medication script sent to a compounding pharmacy of my choice
Unsure - please contact me to discuss

When was my pet last examined by a veterinarian at The Wild Vet?

Within the last 3 months
3–6 months ago
More than 6 months ago
Not sure

supply form, Before

THE WILD VET

Medication Refill Request

medication refill request form

THE WILD VET