Kindness Animal Hospital

1902 Hallie Road
Chippewa Falls, WI 54729

(715)834-2901

www.kindnessah.com

Prescription Refills

In our ongoing effort to make your pet's health care as convenient and easy as possible, you can now request a refill for your pet's prescription by submitting the following form. Please be sure to fill in all the requested information. The prescription refill must be approved by a doctor.

We will notify you via email, phone or text message when your pet's prescription is approved and ready to be picked up. We will also inform you of the total cost of the prescription, and will request a credit card number by phone at that time.  If you would prefer to have the prescription mailed to you, please mention this information in the additional information area. 

Please note this request form is for prescriptions to pick-up at clinic. For mail prescriptions visit our online pharmacy: https://kindnessanimal.vetsfirstchoice.com/ 

Prescription Refills

Name (required)
First Name (required)
Last Name (required)
Address (required)
Street Address (required)
City (required)
,
State / Province (required)
Zip / Postal Code (required)
E-Mail Address (required) :
Daytime Phone
Phone TypePhone Number
Evening Phone (required)
Phone TypePhone Number (required)
Pet's Name (required)

Sex (required)

Male
Female


Age: Years, Months

Have we seen your pet within the last year?

Yes
No


Medication Requested (required)

Additional Comments / Questions


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