- Refilling Your Pets Medications -

Prescription Refill Online Form…

Bienville Veterinarian Hospital is required to follow federal and state regulations for prescribing and dispensing of prescription drugs on this website. These regulations require a valid veterinarian-client-patient relationship, which necessitates a patient record and a recent physical examination.

Please note that prescriptions received by 2:00 PM, Monday thru Friday, will be ready for pick up after 3:00 PM the same day. Prescriptions received after 2:00 PM will be ready the following business day after 9:00 AM.

Last Name:

First Name:

Street Address:

City:

State:

Zip:

Telephone Number (in the event we need to contact you):

Email Address:

Pet’s Name:

Medication to be refilled:

Dosage: mg, weight, etc.

Quantity (number of pills,
capsules, pkgs. etc):

Delivery Method: Pick-up Mail (shipping costs will apply)

Comments or Questions:

Credit Card Type:

Number on Credit Card:

Expiration Date:

Name as it appears on
Credit Card:

Street Address:

City:

State:

Zip:

Bienville Veterinary Hospital
4550 Springhill Avenue
Mobile, Alabama 36608
251-342-2885

Last revised: 7 May, 2007

Home | About Us | General Information | Pet Care | RX Refills | Pet Care Supplies
Find/Adopt A Pet | Photo Gallery | Site Search | Privacy Policy | Legal Terms