Rx Refill

Grant County Veterinary Clinic

490 Helton Road
Williamstown, KY 41097

(859)824-4012

www.grantcountyvet.com

— 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 a doctor. Please allow 24 hours notice for refills.

We will notify you via email or phone when your pet's prescription is approved and ready to be picked up. You may pay for the item/s in person or by credit card number over the phone. If you would prefer to have the prescription mailed to you, please mention this information in the additional information area.

Prescription Refills

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) :

Daytime Phone (required)
Phone Type	Phone Number (required)

Evening Phone
Phone Type	Phone Number

Pet's Name (required)

Sex (required)

Male
Female
Neutered male
Spayed female

Age: Years, Months

Have we seen your pet within the last year?

Yes
No
Unsure

Medication Requested (required)

Additional Comments / Questions

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Grant County Veterinary Clinic

Prescription Refills

Please note we are unavailableMonday thru Friday noon to 1PMexcept for emergency.

Please note we are unavailable
Monday thru Friday noon to 1PM
except for emergency.