Affordable Vet Services

2117 West Stadium Blvd.
Ann Arbor, MI 48103

(734)926-0114

affordablevetservices.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.


 

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)

Sex (required)
Male
Female


Age: Years, Months

Have we seen your pet within the last year?
Yes
No


Medication Requested (required)

Additional Comments / Questions


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