Veterinary Prescription
Please print and complete all of the details below. Then ask your vet to complete and sign the prescription before posting it to Pet Drugs Online.
PRESCRIPTION DETAILS

Owner Information

Title: _____
Forename: ____________________
Surname: ____________________
Address: ____________________
  ____________________
  ____________________
  ____________________
Tel: ___________
FAX: ___________

 

Pet Information

Pet Name: ____________________
Pet Breed: ____________________

Once completed, please attach this prescription, or a signed vet prescription to your order confirmation and send it to:

Pet Drugs Online
5 The Dairy,
Priston Mill,
Priston,
Bath,
BA2 9EQ

FAX: 01225 580077
Tel: 0800 2346742
(Mon-Fri 8am-7pm,
Sat 9am-1pm)

contact@petdrugsonline.co.uk
PRESCRIBING VETERINARY SURGEON
Title: _____
Qualifications:
 ____________________
Forename: ____________________   ____________________
Surname: ____________________   ____________________
Name of Practice: ____________________    
Address: ____________________ Tel: ___________
  ____________________ FAX: ___________
  ____________________  
 Postal Code: ____________________  

I declare that this prescription is for animal(s) under my care.

Signature: ____________________ Date: __/__/____ (dd/mm/yyyy)
PRODUCTS REQUIRED

Product Name
QTY
 Dosage Instructions
     
     
     
     
     
     
Number of Repeats: 1 2 3 4 5 (Please circle as appropriate)