REPEAT PRESCRIPTIONS

Title

Your Name and Surname*

Address Postcode*

Phone Number*

Email*

Pet's Name*

Species (eg. cat, dog, rabbit)*

Current weight (if known)

In your knowledge, have we given your pet a healthcheck within the last 3-6 months?*

Yes

Item 1 : Name of Medication Required

Item 1 : Current dosage you are giving

Item 1 : Quantity usually dispensed

Item 2 : Name of Medication Required

Item 2 : Current dosage you are giving

Item 2 : Quantity usually dispensed

Item 3 : Name of Medication Required

Item 3 : Current dosage you are giving

Item 3 : Quantity usually dispensed

What branch would you like to collect the item(s) from?

Please add any further comments you feel relevant.

We’d like to update you occasionally with pet health news and offers that we think you’ll be interested to hear about. If you do not wish to receive these, please tick below.

Yes please, I would like to receive reminders (i.e. appointments, boosters and treatment reminders)

By Email

By Phone (inc. text)

By Post

Yes please, I would like to receive marketing communications (i.e. products and services)

By Email

By Phone (inc. text)

By Post

I agree to have read and accepted your business terms and privacy policy. Your privacy is important to us and you can find out more about how we use your data from our "Full Privacy Notice" which is available from in the links above, and I am over 18

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Tameside Veterinary Clinic Limited

Registered Address Spitfire House, Aviator Ct, York YO30 4UZ

Company No. 6589306

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