Ann Arbor Animal Hospital 
2150 West Liberty Street, Ann Arbor, MI 48103      734-662-4474

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Prescription Requests

In our ongoing effort to make your pet's health care as convenient and easy as possible, you can now request a refill for your pet's prescription by submitting the following form. Please be sure to fill in all the requested information. The prescription refill must be approved by a doctor. Please allow two (2) business days for your order to be ready If the medication is unavailable we will contact you for alternate plan. if you need your order sooner, please call the hospital at 734-662-4474.

Form - Prescription- Hospital Pickup

Contact Person (required)
First Name (required)
Last Name (required)
Client name pet is registered under, if not same
First Name
Last Name
Daytime Phone (required)
Phone TypePhone Number (required)
Evening Phone
Phone TypePhone Number
E-Mail Address (required) :
Animal's Name (required)

Have we seen your pet within the last year? (required)
Yes
No

Please include script name(s), strength and quanity requested.
Medications Requested (required)

Other questions or concerns:


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