Prescription Request in Placerville, CA | Pleasant Valley Pet Clinic

Please fill out the Prescription Refill Request Form below. If you are requesting the prescription be filled at an outside pharmacy, please put the pharmacy name and fax number in the comments section.

Please provide all information as completely as possible. Once you submit your form a client service representative will contact you.

PLEASE NOTE: WE REQUIRE 24 HRS NOTICE FOR REFILLS.

Any prescriptions requested with less than 24 hrs notice may be subject to a $10.00 rush fee.

Refill requests sent in on weekends will not be filled until Tuesday.

Thank you for choosing Pleasant Valley Pet Clinic

Name*
First Last
Email*
Phone*
Pet's Name*
Medication Requested*
Medication Directions (as you are giving them)*
Amount of Medication Requested*
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