Refill Prescription

By completing the form below, the information will be provided to our pharmacy staff to confirm and refill your prescription.

All fields are required unless marked optional.

About you
How we can reach you
Your refill

List them by the most recent prescription number, or give the name or description of the medication.

Anything else?

Please add any extra details that you think we may need to know when filling your prescription.

We'll contact you by e-mail or phone within one business day. If you haven't heard from us by then, please call 604-848-7059.

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