Medication Refill Form

 We always encourage ordering medications before you think you will need them to be sure you don’t run out.  

VOS Nashville is open Monday-Friday, 8:00-4:00.  Medication requests received after business hours or on weekends or holidays will not be processed until the next business day. 

CHATTANOOGA AND MURFREESBORO PATIENTS:
If you would like to pick up a medication from these offices, please note Chattanooga is closed on Fridays and Murfreesboro is closed on Mondays.  All locations are closed Saturday and Sunday.

Please note: we cannot fill medications for pets that we have never examined, have not examined within a year, or that have experienced changes to their eyes and have not been re-evaluated by their ophthalmologist. Please visit American Veterinary Medical Association‘s website about veterinary pharmacy/prescription regulations for more information.

Please fill out the form below to send a refill request to our office. Your request will be processed within one business day.

"*" indicates required fields

Patient Information

Owner's Name*

First Last

Pet's Name*

Phone*

Email Address*

A valid email address is required for online medication refills. If you would prefer not to use an email address, please call 615-690-9399 and have your payment information ready. We will not sell your address or use your address for anything other than official communications.

Requested Medications

Medication(s)*

Click to enter additional medications.

Name

Quantity

 

Add Remove

Additional Notes:

Delivery Method

Choose how you would like to receive your medication(s).

Mail to my address

Pick up at Clinic

Call prescription to my pharmacy

How would you like to pay?*

Please call me for payment information.

I will call with payment later on. (Order will not be sent until payment is processed.)

Personal Mailing Address*

Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code

Additional Notes

Pickup Location

NashvilleChattanoogaMurfreesboro

Time

MorningLunch TimeAfternoon

Date

Month

Day

Year

Preferred Pharmacy Name and Telephone Number*

Additional Notes

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Name

This field is for validation purposes and should be left unchanged.

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