Borash Veterinary Clinic

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If this is an EMERGENCY, please call: 978-531-8713.

This prescription form is for use by clients whose
pets we have examined within the last 12 months.

First Name:	Required
Last Name:	Required
Pet's Name:	Required
Phone:	Required
E-Mail:	Required

Prescription Refill Request
Medication Requested	Dosage Size / Strength	Quantity Requested





Phone number we can reach you at if we have a problem filling your prescription:

Additional Comments

The refill form is for the convenience of our clients that have previously been given a medication by Dr. Borash. Dr. Borash will review the request, and you will be contacted if it cannot be filled for any reason. An email confirmation or telephone will be sent for filled requests.

Federal and Commonwealth laws, as well as good medical practice, prohibit us from dispensing prescription medications without prior examination of your animal (within the last 12 months), and current knowledge of your animal's health.

We are similarly prohibited from dispensing or refilling medications that were originally ordered by another veterinarian. We will be happy to dispense any needed medications after examining your pet.

Kindly give us at least 24 business hours after submitting this form. Please call before you come to pick up your meds to be sure that your pet's prescription is ready.

Let us know if you would like your prescription mailed. We will call you for a credit card number. The packaging and mailing fee is $5.00 for most prescriptions.