Prescription Request Form

Request your prescription online – it’s quick, easy and convenient.

You have to be seen in the last 6 months to get a prescription otherwise you will need an appointment with a vet.

Title *

First name *

Surname *

Address *

City/Town *

Postcode *

Email address *

Telephone

Pet's name

Item 1

Medication required

Quantity required

Current dose

Item 2

Medication required

Quantity required

Current dose

Item 3

Medication required

Quantity required

Current dose

Comments

Has your pet been seen by the practice in the last six months? *

Delivery service *

Please note: Prescriptions can be sent to you by post at a cost of £6.64. Please note, this option is not available for liquid medication, insulin or diet. By clicking YES to delivery service, your prescriptions will be sent to the address you have entered above. If your prescription order is particularly heavy, the delivery charge may be more than the specified fee. In this instance we will make contact with you to discuss the cost.

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Captcha *

Request your prescription

Moor Cottage Veterinary Hospital