Prescription Refill Form

To request a prescription refill simply fill out our form below and we’ll get back to you by phone or email within one business day of your request. You can also call us at 610-828-3054.

Or download this Word document and complete the form and email back to pharmacy@hickoryvet.com

Teresa Lattanze

Purchasing Agent

Nancy Levin

Pharmacy Assistant / Lab Technician

""
1
Owner's Full Name
Pet's Name
Phone Number

Prescription #1

Medication
Strength (mg/size/cc)
Directions
Quantity

Prescription #2

Medication
Strength (mg/size/cc)
Directions
Quantity
Is this medication to be picked up at Hickory Veterinary Hospital?
If not, provide name and phone number of outside Pharmacy
Additional Comments
0 /
Previous
Next

Helping and healing for over 75 years.

Hickory Veterinary Hospital was founded in 1956 as a team of professionals committed to excellence in animal care. Our continued goal is to deliver the highest quality of veterinary medicine to our patients.