New Prescription

Submit your prescription details and we'll take care of the rest.

Patient Name *

Patient Date of Birth *

Phone Number *

Email *

Street Address

Street Address Line 2

City

Country

Allergies

Prescription #1 *

Upload prescription photo.

Ontario Health Card *

Upload photo of health card.

Drug Plan Card

Upload photo of card.

Notes

Medication will not be dispensed until we have and verify the original.

Questions? Call us at 705-686-3356.