Prescription Refill Request Form

Here For You When Your Veterinarian Can't Be

Prescription Refill

At Animal Emergency Center, we want to make it easy for you to request food and prescription refills for your pet. Just fill out the form below and we will get into contact with you. If you have any questions please call us at (570) 399-0403.

Prescription Refill Request Form

  • Please enter the first name of the pet's owner.
  • Please enter the last name of the pet's owner.
  • Please enter today's date.
  • Please enter the name of your pet.
  • Please enter the date of the prescription.
  • Please enter the name of the medication.
  • Please enter the name of the doctor who prescribed the medication.
  • Please enter your phone number.
    This isn't a valid phone number.
  • Please enter your email address.
    This isn't a valid email address.
  • Please enter a message.

Your Right Choice

When An Emergency Happens
  • Tender Loving Care

    We understand that no one wants to come to an emergency veterinarian, our highly trained staff is here with a compassionate heart to care for you and your pet.

  • Handling Emergencies Big and Small

    Whether you have a life-threating emergency on your hands or just don't want until Monday to see your regular vet, we're here to serve you and your pet.

  • Two Decades of Caring

    We have been a staple in this community for twenty years, put your loved one's paws in our experienced hands.

  • Here When Your Veterinarian Can't Be

    We are proud to serve our community by being open on nights, weekends, and all major holidays.

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Read Our Reviews

  • “Gentle Humor, Kindness and Frankness was Comforting”

    - Denise S.

  • “As soon as I got there around 5 am I was greeted by a friendly staff member. They were able to make sure my baby was okay and helped her feel better by giving her some pain meds.”

    - Halie S.

  • “Tia and Kayla provided phenomenal service in reassuring me everything would be okay through the entire process.”

    - Lacie F.