Yu of Guelph Veterinary Dermatology
519-821-SKIN (7546)

Medication Refill Request Form

This form is for requesting refills of ongoing prescriptions for current patients of Yu of Guelph Veterinary Dermatology. Patients must have been examined within the last year in order to request refills. Authorization for more medication is at the discretion of the veterinarian. We will contact you when your prescription has been approved, or if there are any concerns with refilling this medication. Please ensure all fields are filled out completely to avoid a delay in refills.

Patient Info

Medication Info

Please list any medications, including dose, frequency, and how many you would like:

Medication Dose Frequency administered Amount of pills/tablets/mLs

Pick up location

Other Info