Repeat Prescriptions

To request repeat medications, please complete the form below. Your pet MUST meet the following criteria:

Your pet is a current patient at Eye Vet
Your pet has been examined by one of our ophthalmologists within the last 6 months

Please give 48 hours notice for repeat prescription requests.

Name(Required)

First Last

Email(Required)

Phone(Required)

Pet Name(Required)

Address(Required)

Street Address Address Line 2 City Postcode

Medication(Required)

Please press the ‘+’ symbol to add a new line for each medication that you are requesting.

Medication Requested

Quantity (1 bottle, 2 bottles etc)

Actual Bottle or Written Prescription Only

How often are you administering this medication? (eg 3 times per day)

And where are you administering it (e.g. Left Eye, Right Eye, Both eyes, Mouth):

Medication Posted or Collected?(Required)

Posted

Collected

Ophthalmologist Care the Animal is Under(Required)

Mobile Number for when Medication is Ready(Required)

Is your pet on any new medications from your primary vet? If yes, please state.(Required)

Yes

No

If Yes, please outline below:

How is your pet doing since his/her last visit to Eye Vet?(Required)

When is your next appointment? (if known)(Required)

Pet Owners