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Prescription Refill Request – Neurology & Neurosurgery

  • All prescription refills must be approved by your pet’s neurologist.
  • Prescriptions cannot be refilled for patients that have not been examined by one of our doctors within the past year.
  • If your pet’s medical condition has changed, or if he/she is experiencing problems or suspected side effects, please call 713-341-9520 to discuss your pet's medical condition.
  • When possible we will try to accommodate larger prescriptions, however, certain controlled substances will only be prescribed in 30 day or less quantities.
  • The maximum quantity for a single refill when allowed is 90 days.
  • Please allow a minimum of 24 hours for refills to be processed. If you require medication in less than 24 hours please call 713-341-9520. Additional fees to fill urgent prescription requests may apply.
  • If more than two prescription refills are requested, please fill out a separate form.

Prescription 1

Medication Name:

Medication Strength (from the previous prescription):

Medication Directions (from the previous prescription):

Has your pet’s medication dosage changed since the last prescription?

Quantity Desired:

Please specify:

Prescription 2

Medication Name:

Medication Strength (from the previous prescription):

Medication Directions (from the previous prescription):

Has your pet’s medication dosage changed since the last prescription?

Quantity Desired:

Please specify:

Prescription 3

Medication Name:

Medication Strength (from the previous prescription):

Medication Directions (from the previous prescription):

Has your pet’s medication dosage changed since the last prescription?

Quantity Desired:

Please specify:

Pick Up Medication At:

Your Pharmacy’s Name:

Your Pharmacy’s Telephone Number:

Pet Update

Questions & Comments: