Brentwood Animal Hospital, Inc.

Prescription Refills

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 by submitting the following form. Please be sure to fill in all the requested information.
 
The prescription refill must be approved by the veterinarian. Refill requests submitted online may take up to three business days to process. 

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, and will request a credit card number by phone at that time.  If you would prefer to have the prescription mailed to you, please mention this information in the additional information area.

Your information will remain on the page if you type the incorrect verification (at the bottom of this form). A new verification string will appear allowing you to try again.

Maryland and federal laws dictate how some medication can be refilled. Your online request may be denied under these laws.

Form - 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)
,
E-Mail Address (required) :
Primary Phone to contact you (required)
Phone TypePhone Number (required)
Alternate phone to contact you
Phone TypePhone Number
Cell phone
Phone TypePhone Number
Pet's Name (required)

Sex (required)
Male
Female

Age: Years, Months

Have we seen your pet within the past two months?
Yes
No

Medication Requested (required)

Client ID number (5-digit number, from your pet's prescription label), if known

Additional Comments / Questions


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