Prescription Request

Country Oaks Animal Hospital 12030 Moon Lake Road New Port Richey, Florida 34654 727-857-9977		Hours Monday - Friday 7:30 a.m. - 6:00 p.m. Saturday 8:00 a.m. - 12:00 p.m.
If you have an emergency outside of our normal business hours, please contact Animal Emergency of Pasco at (727) 841-6575

Prescription Request

First Name:
Last Name:
Pet's Name:
Home Phone # :
EMail:
Would you like your prescription mailed to you?
Please note: A shipping and handling fee will be added to your order for heavy packages and bottles.
Please Choose Your Veterinarian:
Prescription Request
Medication Requested	Dosage Size / Strength	Route of Administration	Quantity Requested
Name:
Name:
Name:
Name:
If your pet is taking medication for a chronic problem, please check the Medication Chart for special information or testing recommendations.
Phone number we can reach you at if we have a problem filling your prescription:
Comments

* The refill form is for the convenience of our clients that have previously been given a medication by one of our veterinarians. The prescribing veterinarian will review the request, and you will be contacted if it cannot be filled for some reason.

Federal and State laws, as well as good medical practice, prohibit us from dispensing prescription medications without prior examination of your animal (within the last 12 months), and current knowledge of your animal's health.

We are similarly prohibited from dispensing or refilling medications that were originally ordered by another veterinarian. We will be happy to dispense any needed medications after examining your pet.

Visit our sister hospitals:

Animal Care Center
4041 Little Road
New Port Richey, Fl 34655
(727) 376-7600

Best Care Animal Hospital
6041 Trouble Creek Road
New Port Richey, FL 34653
(727) 846-8899

Please report any problems or suggestions to webmaster@countryoaksah.com

Last updated: March 20, 2008