
Outside Third Party Pharmacy Prescription Request Form
OUTSIDE THIRD PARTY PHARMACY
Please submit this required third party pharmacy request form only if you decline a complimentary written prescription to use directly via the pharmacy of your choice and wish for Dr. Brown or remote staff to phone in your pets new or refill prescription directly to an outside third party pharmacy
There is a $22 fee per call for the time that is needed for Dr. Brown & remote staff to communicate directly with outside third party pharmacies
COMPLIMENTARY WRITTEN PRESCRIPTIONS MYVETSTOREONLINE
PROCESSING INFO
Please allow up to 48-72 business hours for approval and processing
Please request one medication per form to avoid errors
All patients must have an ACTIVE CLIENT PATIENT RELATIONSHIP (current exam by Dr. Brown within 12 months) BY LAW for refills
IMPORTANT
Please confirm directly with the third party pharmacy of your choice PRIOR TO SUBMTTING THIS FORM that the medication being requested is in fact carried by your chosen pharmacy
Please contact your third party pharmacy of choice directly for processing updates
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