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MayfairAnimal Hospital

Ph: 919-467-6146
Fx: 919-319-0197

1130 SW Maynard Rd. Cary, NC 27513

Request Prescription Refill

To help make your pet's health care as convenient and easy as possible, you can use our request a refill form to refill your pet's prescription. Simply fill in all the requested information and we will notify you by email or phone when your pet's prescription is ready for pickup. Please note that only one medication can be requested at a time, and all refills must be approved by one of our veterinarians.

In the event that you are calling in to a pharmacy, please indicate the name of the pharmacy and their phone number.

[*] Required fields

[*] Owner Name / Last Name:


[*] Pet Name:


[*] Email:


[*] Phone:


Pharmacy Name (If Call In Prescription):


Pharmacy Phone Number:


[*] Medication Name:


[*] Dosage(per tablet/capsule/ml):


[*] Quantity:


[*] Amount per dose:


Contact Preference? Phone Email



Request

PRESCRIPTION

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