Prescription Refill Request

If your prescription is being filled at an outside pharmacy, then please call that pharmacy directly if repeat prescriptions are authorized.

Otherwise, please fill out the following form to submit your prescription refill request, or email us directly with the information below at All items in the form below are required to ensure your request will be processed correctly. Please allow 48 hours for processing.

    Owners Full Name*

    Pets Full Name*

    Prescription Drug Name*



    Contact Phone*

    Email Address*

    I want to pick up at Heart of Oregon Veterinary Cardiology, 15800 SW Upper Boones Ferry Rd., Suite 300, Lake Oswego, OR 97035

    Pick up at outside Pharmacy

    Store Name

    Store Phone

    Store Address




    Have Heart of Oregon mail out using Priority Mail (additional $7.15/ 2 business days in addition to 48 hour processing)