Internal Parasite, Flea and Tick Preventative Medication Request Form
Protecting your pet from internal and external parasites is critical for many reasons.Shuswap Veterinary Clinic is here to help. Simply complete the form and click Submit. For multiple pets, please add their information under Additional Information. If we have seen your pet within the last year, you can expect that your medication will be ready within 5 days. A representative will contact you once the order is ready for pick up.If you are a new client or we have not seen your pet within the past year, we may call you to follow up about your request. In some cases, we may need to have you speak with a veterinarian before dispensing medication (particularly for flea and tick preventives).
Your Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your Pet's Name
*
Species?
*
Canine
Feline
Your Pet's Weight
*
My pets weight is based on:
*
Same as last visit
I weighed my pet on a home scale
Guessimate
Do you have a preferred product you have used in the past? If yes, please note the product below; if no simply leave blank.
What prevention are you looking for?
*
General dewormer for internal parasites.
Flea prevention
Flea and tick prevention
Is your pet a hunter or scavenger outdoors?
*
Yes
No
Do you have a preferred product you have used in the past? If yes, please note the name below; if not, simply leave this blank.
For a deworming product for cats, which have you used in the past? One, neither or both.
Oral
Topical
Both
Additional Information and/or Additional Pets. Please list additional pets below complete with pet name, species, weight, the prevention you are wanting and whether it is oral or topical medication.
How many months coverage are you requesting?
*
6 months
3 months
1 month
Other
Submit
Should be Empty: