Wood Veterinary Group Repeat Prescription Request

Complete the quick and easy form below to order repeat prescription medication for your pet.

Please note that we require at least 24 hours’ notice to prepare your order for collection, and that pets and animals on regular medication require a medication review at least every six months (or three months for some conditions).

If we have any queries regarding your order, one of our team will give you a call.

Please be aware that any forms submitted out of normal working hours will not be seen until the next working day. For more urgent requests, please call us on 01452 543990 during our opening hours.

Data Protection: We will use the personal information you give us exclusively for the purpose of ordering repeat medication with us. See our Practice Privacy Policy.

Title(Required)

First Name(Required)

Surname(Required)

Address(Required)

Postcode(Required)

Contact Tel Number(Required)

We will use this number to text to confirm your order is ready to collect

Email(Required)

To your knowledge, have we given your pet a healthcheck in the last 3 – 6 months?(Required)

Yes

Practice you wish to collect your medication from(Required)

Quedgeley

Longlevens

Pet Details

Name of Pet

Species

Current weight (If known)

Medication Details

Name of medication 1 requested

Quantity of medication 1 usually dispensed (i.e. 30 tablets, 10mls)

Current dosage you are giving

Name of medication 2 requested

Quantity of medication 2 usually dispensed (i.e. 30 tablets, 10mls)

Current dosage you are giving

Name of medication 3 requested

Quantity of medication 3 usually dispensed (i.e. 30 tablets, 10mls)

Current dosage you are giving

Name of medication 4 requested

Quantity of medication 4 usually dispensed (i.e. 30 tablets, 10mls)

Current dosage you are giving

Name of medication 5 requested

Quantity of medication 5 usually dispensed (i.e. 30 tablets, 10mls)

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