Medication requests

It is a legal requirement that we can only supply prescriptions for animals that are “under our care”, which generally means that we must have seen them in the past 6 months. If in any doubt, please call us on 01283 733766.

Patient details

Animal's name*

Surname*

Address*

Email*

Drug 1

Drug name*

Drug strength*

Quantity required*

Dose you are currently giving*

I need to order a second drug

Drug 2

Drug name

Drug strength

Quantity required

Dose you are currently giving

I need to order a third drug

Drug 3

Drug name

Drug strength

Quantity required

Dose you are currently giving

Delivery details

Do you require a written prescription or medication?*

Name of pharmacy and order confirmation number*

Please forward your order confirmation to referrals@sarahsmithcardiology.co.uk. The prescription fee must be paid prior to us sending any prescription to the pharmacy.

For medications to be posted, payment must be made prior to drugs being dispatched, unless claiming through insurance. A payment link will be sent to you once the order is ready.

Address to post to

Is this to be submitted through insurance?*
YesNo

Please allow 48 hours for all medication requests (excluding weekends and bank holidays).

Whilst we will always do our best to process requests sooner than this, orders may take longer during busy periods or if we are waiting for deliveries.

Please call us if medication is required urgently.

Medication requests

Patient details

Drug 1

Drug 2

Drug 3

Delivery details

How to find us

Contact

Information

Links