Repeat Prescription Form

Please enter your details below. It will take 48hrs to process these details. If you have an emergency please call our hospital direct on 020 8300 8111. All field marked with an * are mandatory

Your Details

Are you registered a registered client of Parkvets? : *

If you cannot answer YES to the above you will need to register. You cannot order a repeat prescription unless you are registered with us. Please telephone 020 8300 8111 or complete our Online Registration Form

Has your pet been examined by a vet in the last 6 months?: *

Title: *

Surname pet is registered under: *

Address line 1: *

Address line 2:

Town: *

County: *

Postcode: *

Contact telephone No. : *

Email Address : *

How did you hear about us?: *

Pets name : *

Written Prescription only?:

Yes

Are you ordering the items or a written prescription for use with another supplier?

Name of Medication: *

Size of medication required (e.g. 25mg or 10ml bottle) : *

Quantity required (e.g. 30 tablets) : *

Current Dose (e.g. 1 tablet twice daily) : *

Comments:

Approximately how much does your pet weigh? : *

From which of our branches would you like to collect your order? : *

Click Here for an Additional Medication Order

Has your pet been examined in the last 6 months?:

Pet name :

Name of medication:

Size of medication required (e.g. 25mg or 10ml bottle) :

Quantity required (e.g. 30 tablets) :

Current Dose (e.g. 1 tablet twice daily) :

Comments:

Approximately how much does your pet weigh? :

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Math Question: * 8 + 7 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

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