REFILL REQUEST FOR MEDICATION AND/OR FOOD

New Clients please use our New Client Form

Current Clients : Please complete all form fields below and click submit to send your information to us. We will send you a return email to confirm your pickup appointment day and time. If we cannot confirm your appointment as requested, we will advise you either by return email or phone call. If you need an appointment for today or tomorrow, do not use this form. Instead, please call us at (203) 324-5711 to request an appointment. Appointment requests are not confirmed until you receive a reply from us.

NOTE: Current Clients can alternatively book an appointment for a Preventive Care Exam, a Brief Problem Exam, a Medical Progress Exam, or a RX Medication/Food Pickup appointment via the Online Scheduling Module found in the Pet Portal. All other types of appointments should be requested here.

Your Information

Pet Information

Appointment Information

If you are bringing more than one pet, please list here.

Apointment date and time (first choice)

10 minute pickup appointments from 12:00pm to 1:30pm OR 5:30pm to 6:20pm Note: appointment is not confirmed until you hear from us

Appointment date and time (second choice)

10 minute pickup appointments from 12:00pm to 1:30pm OR 5:30pm to 6:20pm Note: appointment is not confirmed until you hear from us
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