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Pet's Name (s)*

Have we examined your pet (s) within the last 12 months?*

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No

Exam Required Prior To Prescription

In order to prescribe medications our veterinarians are required by Missouri law to have examined the pet within the previous 12 months.

Please do not submit this form. Contact our office at 816-229-1544 to schedule an appointment.

Inform us at your appointment that you would like to sign up for Subscribe & Remind and we will get you started at that time. Thank you!

What product(s) would you like by subscription?*

Sentinel Heartworm Prevention
Simparica Flea/Tick Control
Revolution Heartworm/Flea Control (Cats)
Other

What other product would you like by subscription? NOTE: Subscriptions are not available on all products but we will accommodate your request if possible.*

Heartworm Testing

If your dog has not been taking a heartworm preventative during the last 60 days, then we must do a heartworm test prior to starting prevention. Preventatives can have severe side effects if your pet is already infected with heartworms.

Heartworm Preventative Doses*

My pet has been taking Heartworm Prevention and has had a dose in the last 60 days.
My pet has not had a dose of preventative in the last 60 days.

Testing Required Prior To Prescription

Please do not submit this request form. Contact our office at 816-229-1544 to schedule an appointment for heartworm testing.

Remind us at your appointment that you would like to be signed up for Subscribe and Remind so we can start your subscription as soon your dog has a negative heartworm test.

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