Online Forms

Request your pet’s medication online! Please fill out the form below, and one of our team members will contact you when your pet’s prescription is ready to be picked up if they are eligible for refills. All pets must have a current exam on file within the past 12 months and be current on blood work for certain medications.

ALL medication requests require a doctor’s approval, please allow 24-48 hours for your request to be processed. If you need immediate refill assistance or have questions about your pet’s medication, please call the office at 352-567-7496.

Please note: This refill request is for prescription pick up at Blake Veterinary Hospital. This is not a request for delivery.

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  • Pet Information

  • Referral Information

  • By checking below you certify that you are the owner and or agent of the above animal and have the authorization to consent to treatment if and when it is needed.
  • Owner Information

  • Pet Information

  • Dates of Boarding

  • MM slash DD slash YYYY
  • :
  • MM slash DD slash YYYY
  • :
  • *Note: Please call to confirm drop off and pickup times and boarding availability.
  • Emergency Contact Information

  • Additional Services

    Note: Charges may apply for additional services
  • Medications and Special Instructions

  • Being away from home can be a stressful experience for some pets. I give permission for treatment and assume payment if my pet becomes ill while boarding.
  • This field is for validation purposes and should be left unchanged.