Prescription Referral Form
Akina Animal Health Prescription Referral Form
We’ve made prescribing easy to save you and your staff time. From here you can:
Download the fillable prescription form, complete all of the appropriate information, fax it to Akina Animal Health and we will take it from there
Complete and submit the online form below. We will contact you to confirm receipt of the order and to verify the details of the prescription order.
This section is for prescribers only.
Prescription forms can only be completed and transmitted by the prescriber.
Prescription Referral Form Online
Complete the form below with as much detail as possible and submit.
Once we receive the completed referral form we will:
- Notify the Pet Parent that we have received the prescription and provide an update of the status
- We will discuss the medication(s) with the pet parent, any possible side effects, and how to contact Akina Animal Health with questions
- We will coordinate for shipping directly to the pet parent or arrange for pick up upon request
- Our KiND Care Coordinators partner with you and the pet parent throughout the course of therapy to increase compliance, monitor side effects, and ensure access to all needed resources
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