Skip to main content
Main menu
Reorder Medicines & Vaccines
Webform
Medication (oral and topical) and injectable/oral allergy vaccine refill form
What would you like to refill?
*
- Select -
Oral or topical medication
Injectable or oral allergy vaccine
Pet's name
*
As it appears on the account
Your first name
*
As it appears on the account
Your last name
*
As it appears on the account
Phone number
*
Email
*
How would you like to be contacted when the refill is ready?
*
Email
Phone
How would you like to receive your refill?
*
Pick up during hours
Pick up after hours
Ship to an address
Address 1
*
Address 2
City
*
State
*
- Select -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
*
Medication
*
Please enter the oral or topical medication (including the dosage size/strength, and quantity requested). You can submit multiple requests on one order form.
Vaccine
*
Please enter the type of allergy vaccine (specify if oral or injectable) that you wish to refill. You can submit multiple requests on one order form.
Do you need syringes/needles?
No
Yes
Comments
Information
(301) 977-9169
(Phone)
(301) 977-7196 (Fax)
15942A Shady Grove Rd
Gaithersburg, MD 20877
? Top