Request A Prescription From Your Veterinarian

All prescription drug products require a valid prescription from a licensed veterinarian. We can reach out to your veterinarian for you if you would like us to. Please fill out the form below to provide us with the information we need.

Owner's Name

First Name

Last Name

Animal's Name

First Name

Last Name

Species

Animal's Gender

Animal's Date of Birth

Owner's Email

Owner's Phone

(###)

###

####

Owner's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Medication

Veterinarian's Name

First Name

Last Name

Veterinarian's Clinic Name

Veterinarian's Clinic Phone Number

How did you hear about us?

Other information you would like us to know

Location

193 Coy Road, Suite 200
Weatherford, TX 76087

Hours

Monday — Friday
8am — 5pm

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All Right’s Reserved

Contact Us

Local: (817) 661-0758

Toll Free: (888) 982-9228

Fax: (817) 661-0618

Email: ask@xactrx.com