Clinic Auto Refill - Meds for Vets

Auto-Refill Enrollment Form

Thank you for your interest in Meds for Vets auto refill program. Please submit this form to begin enrollment.

Account Name *

Animal Owner or Clinic? *

Email *

Account Phone Number *

RX Number's & Medication Descriptions for drugs you want to register for auto refill...

Select Auto-Refill Frequency *

Enter Frequency

Shipping Address

Address Line 1

Address Line 2

City

State

Zip Code

Free USPS first class shipping (7-10 days) for any RX# enrolled weighing less than 1lb. (excludes controlled substances and medication requiring expedited shipping). If you want faster shipping please let us know here and receive a $3 credit towards faster shipping. Along with your address.

Do you want to be contacted by Text or Email for Refills? *

Text
Email

Last four numbers of Credit Card on file, Expiration Date, CVC code *

Credit Card Agreement & Terms of Refills *

I Agree to the Terms Below

I authorize that all future payments and applicable prescription costs will be charged to the credit card on file for the frequency chosen. I understand that a compounded medication will not be made until payment is processed given refills are available; payment and lack of refills may cause delivery delays of medication. I also understand that compounded medications cannot be returned to the pharmacy for credit. *Enrollment in the auto refill program is required on a yearly basis.