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Online Prescription Refill
for Western Veterinary Clinic Patients

Use the form below to make an online request for prescription refills. Please allow for 48 hours to prepare your request. If you need a prescription immeditally please call the office at 574-234-3098.

You must fill out each field below in order to process this form.

Your Name:


Your e-mail:


Pet's Name:


WVC Account Number:


Best Contact Phone Number
(if a doctor needs to contact you)


Type verification image:
verification image, type it in the box

List prescriptions, instructions, or message:
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25190 State Road 2, South Bend, IN 46619
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