Other Options REFILL MY PRESCRIPTION MY PRESCRIPTION IS AT ANOTHER PHARMACY Other Options REFILL MY PRESCRIPTION MY PRESCRIPTION IS AT ANOTHER PHARMACY Other Options REFILL MY PRESCRIPTION MY PRESCRIPTION IS AT ANOTHER PHARMACY New Prescription Kindly fill the below details. * are mandatory fields PERSONAL DETAILS Name* Phone number* Email* Date of Birth Date12345678910111213141516171819202122232425262728293031 MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year202020192018201720162015201420132012201120102009200820072006200520042003200220012000 PRESCRIPTION DETAILS Upload a file BROWSE To fill a new prescription please upload a photo of the prescription and complete the form below. Please make sure to capture the entire page in your photo. What prescription(s) would you like us to prepare for you? * I PREFER Delivery Pick-up Preferred Contact Method * Phone Email Retain Prescription * I understand that Ontario law requires the dispensing pharmacy to maintain the original prescription. I confirm I will maintain my original prescription for pharmacy collection. Additional Notes Your order will be processed during regular business hours. total_healthNew Prescription06.23.2020
