Request a Prescription Refill

PLEASE NOTE:

• If it is more than 3 months since your last appointment at WAVES, you may need to schedule a consult before your medication can be refilled.  
• Please note that it will take a minimum of 3 business/weekdays to process your request. If the information below is incomplete, processing your request may be delayed.
• If you have run out of medication and this is now an emergency, please contact client services by calling 778-432-4322 for more information.
  

Contact Us

Today's Date *

CLIENT INFORMATION

Owner's Name *

First

Last

Phone Number *

PATIENT INFORMATION

Pet's Name *

Species *SELECT ONEDOGCATOTHER

Please specify: *

Species

Age/Date of Birth *

PATIENT HISTORY

When was pet last seen by this hospital?

If it is more than 3 months since your last appointment at WAVES, you may need to schedule a consult before your medication can be refilled.

Which department prescribed it in the past? *SELECT ONEINTERNAL MEDICINENEUROLOGYSURGERY

Notes:

Did you try to get it refilled at your regular veterinary clinic? *SELECT ONEYESNOI DON'T KNOW

Notes:

How is pet's overall health since last visit? *SELECT ONESAMEWORSEBETTER

Notes:

Has it been prescribed here before? *SELECT ONEYESNOI DON'T KNOW

Notes:

Is the medication helping? *SELECT ONEYESNOI DON'T KNOW

Notes:

REQUESTED REFILLS

Are you refilling more than one medication? *

• Yes
• No

Medication Refill(s)

Layout

Medication

Medication Strength (e.g. mg, g)

Current Dose (e.g. 1 tablet three times a day)

Amount Requested (e.g. 30 days)

How much medication remaining

Medication

Medication Strength

Current Dose

Amount Requested

How much medication remaining

Medication

Medication Strength

Current Dose

Amount Requested

How much medication remaining

Medication

Medication Strength

Current Dose

Amount Requested

How much medication remaining

Medication

Medication Strength

Current Dose (e.g. 1 tablet three times a day)

Amount Requested

How much medication remaining

Upload photo(s) of prescription labels

Click or drag files to this area to upload. You can upload up to 8 files.

OPTIONAL

To ensure you are a human, please answer the following question: *

Which of these is a fruit? Options: Apple, Chair, Dog, Car)

Submit