Repeat Prescription Request Form
A repeat prescription template — pet, medication and last check-up captured, so refills are processed safely and without a needless visit.
Description
Form fields
Everything the Repeat Prescription Request Form above collects — 10 fields, so you can see exactly what it captures before you make it your own.
Request a Repeat Prescription
Pet's name
Short Answer
Medication name & strength
Short Answer
Dose & how often
Short Answer
Quantity needed
Short Answer
Date of last check-up / review
Date
Collection or delivery?
Single-Select
Anything else we should know?
Long Answer
Your name
Name
Contact number
Telephone
Email address

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Template FAQs
Common questions about the Repeat Prescription Request Form — what it captures, when to use it, and how to make it your own.
How do I request a repeat prescription for my pet?
Give the pet’s details, the medication name, strength and dose, how much you need, and the date of the last check-up. The vet reviews it and either approves the repeat or advises that a review is due first.
Why does my pet need a check-up for repeats?
Because medication reviews keep your pet safe — making sure the drug and dose are still right as things change. Vets are required to reassess periodically before continuing a prescription; the form captures the last review date to manage this.
How long do repeat requests take?
Practices usually ask for a bit of notice — often a day or two — to review and dispense safely. The form lets you request ahead so you don’t run out.
Can I get my pet's medication delivered?
Depending on the practice — the form captures whether you’d prefer collection or delivery, and the practice will confirm what it offers.
Can I request a written prescription to buy elsewhere?
Often yes — you’re entitled to ask for a written prescription to purchase medication from another supplier. Note it on the form and the practice will advise on any prescription fee.
Is the request form free?
Yes — free with a Fun Forms account, fully customisable, and ready to embed or share as a link.
No credit card
Unlimited forms
Unlimited results







