Prescription Refill Request Form

How would you like to get your medications?
Synergy In-House PharmacyOnline Pharmacy - aka CovetrusMy Pharmacy (describe below)


If you selected My Pharmacy above:

1) Please indicate your pharmacy (examples: Walgreens on 32nd, Costco at 138th, etc.) below...

2) Please contact your pharmacy directly and ask them to initiate a Refill Request with us. This will lessen the likelihood of an error on their part.


Please review the following and click the check box to indicate that you understand and accept the conditions for submitting

Our veterinary staff will review your prescription request during our standard business hours, Sunday at 9am through Thursday at 3pm.

We strive to fill prescriptions within three business days from receipt. Please note that this means that if we receive a request on Thursday after 3pm, the prescription will likely not be filled earlier than the end of day on the Tuesday following that.

If there is some urgency to your request, we suggest that you also call us directly or email us to let us know.

I Agree

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