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Request A Refill

Name(Required)

First

Last

How would you prefer us to contact you?(Required)

Email

Phone

Either

Phone(Required)

Email(Required)

How would you like to receive your prescription(s)?

I would like to pick this up at the hospital.

I would like the filled through your online pharmacy.

Please call the prescription into the following pharmacy:

Pharmacy Name(Required)

Pharmacy Phone Number(Required)

Pet's Name(Required)

Medication #1 Name(Required)

Medication #1 Strength (ex: 100mg)(Required)

Medication #1 Quantity Desired(Required)

Medication #1 – How often are you giving this medication (ex: once daily, twice daily, only as needed, etc)(Required)

Do you need another medication refilled?(Required)

Yes

No

Do you need another medication refilled?(Required)

MM slash DD slash YYYY

Choose One

I am OUT of medication

I have a 1-4 day supply left

I have more than a 5-day supply left

Is your pet otherwise doing well at home – normal appetite, energy and no signs of illness (vomiting, diarrhea, coughing, sneezing, limping, etc)?

Yes

No

I understand that prescription refills may take up 48-72 hours to be filled and that I will be contacted once my pet's medication is ready to be picked up.(Required)

I have read and understand.

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What's Next

1
Call us or schedule an appointment online.
2
Meet with a doctor for an initial exam.
3
Put a plan together for your pet.

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Health & Harmony Animal Hospital

614-360-3941

1117 W 1st Ave,
Columbus, OH 43212

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Home
Our Hospital
Services
Pet Health
- Nutrition Recommendations
- Helpful Links
New Clients
Contact Us
- Request A Refill
- Emergency

Monday

8:00am - 7:00pm

Tuesday

8:00am - 6:00pm

Wednesday

8:00am - 6:00pm, Closed 12:30-2:30pm

Thursday

8:00am - 7:00pm

Friday

8:00am - 6:00pm, Closed 12:30-2:30pm

Saturday

Closed

Sunday

Closed

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