Pet medication refills

This request form is for current clients ONLY. If you are a new client, please contact us to discuss your pet’s medication requirements.

Instructions
1. Please fill out this form with accurate details.
2. Once you have submitted the form, you will receive a confirmation email.
3. When your medication is ready to be collected, you will be contacted by phone.
4. Payment will be made upon collection.

Please note:
- It may take up to 3 business days to process your order.
- If you have an urgent request, please call us on 03 9877 3277
- We may contact you to confirm details on this form using the phone number you provided.

Conditions of use
- Blackburn Animal Hospital has the right to refuse medication if your pet has not been seen by a veterinarian within the last 6 months.

Medication Refill Request Form

Name

First Name

Last Name

Phone number

Subject

Are you currently a client of Blackburn Animal Hospital

Your pet's name

Last name is the client last name your pet is listed under

First Name

Last Name

What breed is your pet?

How old is your pet?

When was the last time your pet had a vet check?

What is the name of the medication your pet is currently taking?

What is the dose rate of the medication you have been giving? E.g. 1 tablet twice a day

Have you noticed any changes in your pet's behaviour or health recently? Please list anything that you have noticed.

Do you need this medication urgently? Please only answer yes if you will be missing a dose or are going away.

Do you have questions about your pets medication or anything else?

Call us

Pet medication refills

Medication Refill Request Form

Do you have questions about your pets medication or anything else?

Blackburn Animal Hospital

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