Prescription Refill

Pet Owner Information
- Thank you for using our online prescription refill system. If you have authorized refills available, they will be available for pick-up next business day at the WVRC location of your choice. If you do not have any refills remaining, we will contact the prescribing veterinarian for authorization of a refill. Please allow an additional 48-72 hours for this to be completed. We will communicate any related issues via email or phone.
- First Name*
- Last Name*
- Email*
- Phone Number*
- Preferred Method of Communication*
  - Phone
  - Email
- Select your preferred Pick up Option*
  - Pick up at WVRC - Waukesha
  - Pick up at WVRC - Grafton
  - Pick up at WVRC - Racine/Kenosha
  - Mail to my home address
- We will call you for payment arrangements. Shipping can take 2-3 business days after the prescription is complete as we use standard US Mail. Due to federal law, certain controlled medications cannot be mailed.
- Address
- City
- State
- Zip Code
- Patient Information
- Which WVRC hospital is your pet a patient of?*
- Pet's Name*
- Doctor's Name*
- Prescription Information
- Please provide the following information for each prescription*
  Rx ID Medication Name Dose/Strength
  
  The Prescription ID number is located on the upper right hand portion of your prescription label.
- Additional Comments
Comments
This field is for validation purposes and should be left unchanged.

Rx ID	Medication Name	Dose/Strength

Pet Owner Information