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Fireworks/Thunderstorm Anxiety Medication Request

Please complete the form below to request a new prescription for anxiety medication. If this is a refill, please submit a refill request. Thank you!

First Name*:

Last Name*:

Email:

Phone:

What behavior does your pet display during fireworks or storms? (i.e. hides, digs, chews on things)*

Besides medication, what have you already tried to help with your pet's stress level during fireworks or storms?*

Has your pet used sedatives before for fireworks or storms?*

Yes

Does your pet have a history of seizures?*

Yes

What medications is your pet currently on?*

Pet’s current weight in pounds*

18142 Wright Street
Omaha, NE 68130
(402) 333-3366

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Monday: 8:00am - 5:30pm
Tuesday: 8:00am - 5:30pm
Wednesday: 8:00am - 5:30pm
Thursday: 8:00am - 5:30pm
Friday: 8:00am - 6:00pm
Saturday: Closed
Sunday: Closed