Prescriptions can be created from 2 key areas:

After you've navigated to the Rx section of the SOAP, click the + Add New button. This will redirect you to the prescription creation page where you'll define the details of your prescription.

From the patient profile, navigate to the Prescriptions tab. Here you'll find any previous prescriptions listed, and can also create a new prescription by selecting the + Add Rx button.

This field indicates the medication you are prescribing. For in-house prescriptions, the medication field is a dropdown menu used to search your existing item list. For written prescriptions, the medication field is a free-type text box where you will enter the medication name manually.

In-House prescriptions are automatically recognized as involving a controlled medication based on your medication admin settings. If a medication prescription is not recording within your controlled drug report as expected, ensure you've indicated the medication as controlled within your product settings.

If you select Written as the prescription type, you'll be additionally offered a checkbox to indicate the written prescription is handling a controlled substance.

When a prescription is marked as handling a chronic medication, this will add additional filtering capabilities when viewing a patient's prescription list to more easily recall commonly discussed prescriptions.

On written prescriptions, when Substitutions Permitted is marked, an alternative signature line will appear on written prescriptions with the Dr signature placed accordingly. When this election is not marked, the prescribing Dr signature will be placed in alignment with the Dispense as Written signature line.
​

This field indicates the quantity you wish to prescribe for each refill, or the initial dispensing if no refills are indicated.

This field indicates the number of refills permissible within the prescription's validity period. Indicating PRN refills will mute this field, and you cannot define a specific refill quantity.

Indicating that refills are permissible as needed (PRN) is available for both in-house and written prescriptions. Selecting this option allows refills as needed. PRN indicated refills are not valid past the original prescription expiration date.

This date field indicates the validity of the prescription. This typically aligns with the VCPR (veterinarian-client-patient relationship) expiration to when the next exam is required, or the expiration of the prescription to when the treatment should be concluded. The default expiration of this field is 12 months from the date of the prescription creation, but it is fully customizable.

This date field relates to the expiration date of the prescription medication. This field is only offered for in-house prescriptions. The default expiration of this field is 12 months from the date of the prescription creation, but it is fully customizable.

For clinics with inventory lot tracking enabled, lot details appear inline on the prescription form, showing Administered Quantity, Available Quantity, and Remaining Quantity for each lot. Use the + Create New Lot button to add a new lot directly from the prescription form if needed.
​

When refills are configured, a quantity summary appears at the bottom of the prescription form:

Enabling the quantity calculator via the available toggle will provide calculation fields to assist with determining your total prescription quantity based on dose and the number of doses involved in the complete treatment.

Use the free-type direction field to specify the administration instructions for your clients when giving the medication to their pet. You can utilize pre-defined clinic shortcuts to add efficiency into your prescribing workflow. Default prescription directions can also be custom configured within your item settings and will automatically appear once you've selected the medication. Prescription directions print on the Rx label or written prescription.

This is the veterinarian approving and prescribing the medication treatment. The prescribing doctor is the default production user recognized within production reporting.

The production user field defaults to the prescribing doctor if the prescribing doctor has production tracking enabled. If the prescribing doctor does not, the field will default to unassigned. You can customize the selection manually at any time. If you have the setting enabled to require production user assignments, you will need to make a valid user selection before being able to proceed with saving the prescription.

Add medication-specific information, such as guidance on possible adverse reactions or additional follow-up care instructions, to the discharge instructions area. You can manually add custom discharge instruction text, upload documents, or modify automatically imported discharge instructions that can be pre-defined within your item's admin settings.

Once the appropriate fields have been filled out, select Save and Print or Save to add it to the patient record and invoice simultaneously, and automatically populate any discharge instructions associated with the prescription.

For more information on printing Rx labels, check out our help article on Printers and Prescription Labels.
​

From the patient profile Prescriptions tab, selecting a prescription opens the prescription detail view. The detail view includes:

If a prescription was created accidentally, or the client subsequently declines the prescription, you can cancel or delete the Rx. From within the SOAP, navigate to the Rx tab and locate the prescription row that needs updating. Along the right side you will see several action icons — select the edit pencil to open the prescription details.

Within the prescription details, you will see an X icon (Cancel) towards the upper portion of the prescription. Selecting this icon will initiate the cancel action and request a cancellation reason before concluding the prescription cancellation. Before initiating the cancellation, ensure the SOAP note is unlocked. After completing the cancellation, re-lock the SOAP note to finalize the updates.

A prescription cancellation is similar to a delete or void event. The record of the prescription will be removed from the SOAP and patient history once cancelled. Cancellation also ensures that medications are returned to inventory and removed from production records, maintaining accurate inventory and patient history.

You can view cancelled prescriptions from the Patient profile Prescription tab when you toggle "Show Cancelled" ON.

From the Patient profile, navigate to the Prescription tab and locate the prescription row. Select the circle icon with an X to initiate the cancel action, then confirm a cancellation reason before proceeding.

For unpicked or unpaid prescriptions, cancellation is the recommended approach to maintain accurate records and inventory. Cancel the prescription and create a new one when the patient is ready to pick up. Use the return method only when cancellation is not possible — for example, when a refill is out of order and the system does not allow cancellation.
​

Returns are processed from the checked-out invoice for the prescription. The effect on the prescription and remaining refills depends on the quantity returned.

After a partial return, the prescription detail will show a Returned Refill entry with a banner explaining that refills have been ended. The refill count on the donut chart will show 0 remaining. The lot section will display both the original dispensed-from lot and the returned-to lot. The prescription can still be renewed if you wish to continue providing the medication.

From the patient's profile, you can access a complete prescription list by selecting the Prescription tab. Here you'll have access to search and filtering features in addition to action options.

Use the free-type search bar to manually recall any prescription based on key phrases.

Use the Show Chronic Medication toggle to recall prescriptions marked as chronic medications.

Use the Show Cancelled toggle to view a history of cancelled prescriptions.

Double click the pin icon to pin a prescription row at the top of the prescription list for efficient recall of commonly handled medications.

Use the circular medication icon to duplicate an expired prescription, creating a new prescription with pre-defined fields. This is helpful when you want to create a new prescription similar to an existing one. A renewed prescription will open a new prescription page with suggested details from the existing prescription. Cancelled prescriptions do not support renewal capabilities.

Prescriptions can only be renewed if there are no refills remaining, or if the prescription validity date has expired.

When converting an estimate to a treatment plan, toggle on the Rx toggle to ensure items populate the Rx tab instead of duplicating on the invoice.
​

Cancel prescriptions that are never picked up to remove them from invoices and prevent negative balances. Assign a dedicated invoice status — such as "Ready for Pickup" — to invoices for unpicked medications, then filter out that status when generating month-end statements to exclude these items.

Within the Prescriptions tab of the Patient profile, you'll find a Download button. Selecting this will allow you to export a history of prescriptions for the patient, with or without discharge instructions included. You can export the prescription list for a specific time range or request the entire record.

Shepherd integrates with several prescription pharmacies. Prescriptions handled via an integration will be listed in a separate table outside of the main Shepherd prescription table.

The Cancel button is not available when the SOAP is locked or the invoice is in a Checked Out status. Set the invoice back to Active and ensure the SOAP is unlocked before attempting to cancel.

A prescription cannot be cancelled if a subsequent refill has been processed. The most recent refill must be returned or cancelled first, and refills must be handled in reverse order before the original prescription can be cancelled.

If the prescription uses PRN refills, turn off Refills PRN. If the prescription has a numbered refill count, set refills to 0. Either approach prevents future refills while preserving the original prescription in the patient's history.

The prescription detail page loads the most recent refill by default. If the instructions or quantity look different from the original fill, select Show History to view and print earlier fills. The original dispensed quantity and inventory records remain unchanged.