Requests & prescriptions

Requests & prescriptions. What's the difference?

    On this page you will find two online forms to facilitate you to submit a request for an “orphan drug” delivery or fill out a veterinary prescription for a patient. By using online forms, the chance of an error in the required medicinal product, quantity, dosage, etc. is reduced. To accept a request or prescription, some additional information is required under the law (Wet Dieren) because the medication we distribute is either a magistral preparation/compounded product, imported from other countries or not authorized for veterinary use (human medicinal product). For those reasons the products are categorized as 'Cascade'. Please provide us with the following information:


    • name of the medicinal product, the strength and the quantity (in ml or pieces)
    • name and address of the veterinary practice and the name of the responsible veterinarian
    • name of the patient, the species and the name of the owner

     

    A question, complaint or side effect? Click here
    Price listing & terms and conditions

    All forms provided by Apotheek faculteit Diergeneeskunde (Veterinary Pharmacy) are in Dutch, but have been made accessible in English, German and French, using Google translate. Other languages are available, but haven't been tested for their accuracy and can only be used at your own risk. The Veterinary Pharmacy of University Utrecht is not responsible for any mistakes made in filling out the form after using one of the non-listed languages.

    For people who don't know how to automatically translate online forms, a short instruction can be found below by opening the folded text under 'Translate the forms to English/German/French'. 

      Request orphan drug

      If you want to order products from Apotheek faculteit Diergeneeskunde and have them delivered at the veterinary practice in order to dispense the medication to patient (owners) yourself, you can place a request using the online form orphan drugs. These products will be provided with a general dispensing label, which can be removed and replaced or covered with a label of your own, containing the necessary dosing instructions.

      For some items in the orphan drug form, patient details are required in order to process the request. For these items, the necessary fields of species and patient name, will automatically appear within the form.

      Request form orphan drugs

      Veterinary prescription form

      Instead of requesting products for the veterinary practice, it is also possible to fill out a veterinary prescription for patients in order to have the medication directly dispensed and billed to the owner. For this the veterinary prescription form can be used. In the form you can specify whether the medication will be collected at the pharmacy or has to be sent to the home address of the owner via postal services. 

      In order to dispense medication directly to a patient (owner), information about the use, weight and contact information of the owner are needed. This way the necessary medication dosing and safety checks can be performed and the proper instructions can be printed on the label for the owner.

      Veterinary prescription form

      Note! If you can't find a medicine in the dropdown list, the field for 'other products, not in list' can be used for the request.  

      Most products that are distributed by Veterinary Pharmacy, are unlicensed products that aren't available via the regular veterinary channels and can't be compounded by regular pharmacies (s.c. 'orphan drugs'). Mainly this applies to products that have a complicated production process or with special active substances. As soon as an authorized veterinary medicinal product is introduced to the market, the Veterinary Pharmacy will stop the production and distribution of the orphan drug. 

      Questions? Ask them!