The WellPet Group PC

766 N. Lee Hwy
Lexington, VA , VA 24450

(540)464-1516

www.thewellpetgroup.com

 

Prescription Refill Form


In our ongoing effort to make your pet's health care as convenient and easy as possible, you can now request a refill for your pet's prescription medications by submitting the following form. Please be sure to fill in all the requested information. The prescription refill must be approved by a doctor

     

We will notify you via email or phone when your pet's prescription is approved and ready to be picked up. We will also inform you of the total cost of the prescription. If you would prefer to have the prescription mailed to you, please mention this information in the additional information area

        

Prescription Refills Online

Name (required)
First Name (required)
Last Name (required)
Address (required)
Street Address (required)
City (required)
,
State / Province (required)
Zip / Postal Code (required)
Email Address (required) :
Phone Number (required)
Phone TypePhone Number (required)
Pet's Name (required)

Sex (required)

Male
Female


Age (required)

Have we seen your pet within the last year?

Yes
No


Medication Requested (required)

Additional Comments / Questions


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