Mountain Park Animal Hospital

5324 Five Forks Trickum Road
Lilburn, GA 30047

(770)921-2965

mpah.net

Prescription Refills

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.

We will notify you via email or phone when your pet's prescription is approved and ready to be picked up. We can also inform you of the total cost of the prescription. 

If you would prefer to have the prescription mailed to you, please use our On-Line store. This can be accessed by clicking on the button on the menu to the left. You will need to set up an account and then you can select what products/medications you would like. Your request will then be sent to us to have a doctor evaluate it and once approved the products will be shipped to you.

Prescription Refills Online

Name (required)
First Name (required)
Last Name (required)
Address (required)
Street Address (required)
City (required)
,
State / Province (required)
Zip / Postal Code (required)
E-Mail Address (required) :
Daytime Phone
Phone TypePhone Number
Evening Phone (required)
Phone TypePhone Number (required)
Pet's Name (required)

Sex (required)
Male
Female


Age: Years, Months

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


Medication Requested (required)

Additional Comments / Questions


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