Contact New Client Form RX/Food Reorder

Please complete all form fields and click submit to send the form information to us. Your order is not confirmed and/or available for pick-up until you receive a reply from us. Please allow one working day for most orders to be ready for pick-up. Certain orders may require extra-time for special-ordering or back-ordering. Online RX/Food ordering is only available for pets we have seen, and prescriptions that have available refills. Your Name Street Address City, State, Zip Best Phone# for appointment confirmation E-mail Pet Name Species Dog     Cat     Other If Other Species Name of drug/diet drug example: Thyroxine diet example: Sci Diet Feline c/d Drug Strength drug example: 0.3 mg Quantity drug example: 100 tablets diet example: 20 lb bag What is the best way to contact you? Phone       E-mail     When you are finished, click submit to send the form information

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