Prescription Refill Request

Request Your Pet's Medication Here

If you already have your pet portal access and have refills remaining on your pet's prescription CLICK HERE to sign in and order.

All other medication requests may be submitted using the form below. You will be notified once your pet's prescription is ready. Please allow 24 - 48 hours for your script to be filled.  You will receive a phone call when your medication is ready.

Medication Request Form

Please allow 24-48 hours for requests to be filled. You will receive a phone call when your order is ready.

Do you already have your pet portal access? If you have refills remaining on your pets prescription, CLICK HERE to sign in and order.

All other medication requests may be submitted using the form below. You will be notified once your pet's prescription is ready for pick-up!

    All fields are required.

    First Name:

    Last Name:

    Email Address:

    Phone Number:

    Patient's Name:

    Name of Medication:

    Concentration of Medication (eg, 75mg:):

    Quantity Desired:

    Will you be picking up at Absecon Veterinary Hospital or calling into a pharmacy?

    Name of Pharmacy:

    Pharmacy Phone Number

    Please list any other comments here::

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