Repeat Prescriptions Please use this form to request a repeat prescription for your pet. Contact Details Your Name (required) Your Address (required) Post Code(required) Phone Number (required) Your Email (required) Species (required) CatDogOther If other, please name type eg rabbit, parrot etc Name Of Pet (required) Medication 1 - Name (required) NB subject to vets approval Quantity / Number of tablets (required) NB subject to vets approval Medication 2 - Name Quantity / Number of tablets NB subject to vets approval Medication 3 - Name Quantity / Number of tablets NB subject to vets approval I Would Like To Collect The Prescription From Please indicate your preferred collection location using the buttons below. ChorleyLeylandCoppull Add A Message If Required I'd like to receive more information. I understand and agree to the Privacy Policy, please tick box.I AGREE (required) Please answer this Anti-Spam question (required) Which of 49, 4, 7 and 60 is the smallest?