York Veterinary Hospital

4628 George Washington Memorial Highway
Yorktown, VA 23692

(757)898-3700

www.york-vet.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.

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. 

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) :
Daytime Phone
Phone TypePhone Number
Evening Phone (required)
Phone TypePhone Number (required)
Pet's Name (required)

Species

Prescription Information
Name of Medication (required)

Medication Strength

How often are you presently administering the medication to your pet?

Please choose date to pick-up, allowing 24 Hours for processing and preparation.

Please list any special requests or additional information. Also, if you have noticed any behavior out of the ordinary since your pet has been taking this medication, please describe here.


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