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    PRESCRIPTION REQUEST FORM

                                                                                                                                             

    Today's Date


    Please provide the following contact information:

First Name

Last Name

Phone

    Pet's name


    Drug

 

    Dose

mg

    Quantity

                   Comments

 

Please allow up to 48 hours for your prescription to be filled. We will call you when your prescription is ready or if we have any questions.

Per Florida law, you must have a current veterinarian - client - patient relationship for us to dispense prescription medication for your pet. This includes your pet being examined by us within the past 12 months.

 

  

 

 

WELCOME    DOCTORS    SERVICES    LOCATION & DIRECTIONS     EMERGENCIES    FORMS & LINKS 

Antigua Veterinary Practice
Eric Searcy DVM and John Yselonia DVM
195 San Marco Ave.
St. Augustine, Florida

904-824-1414

Fax 904-824-7888


doctors@antiguavet.com

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