Prescription Transfer

Do you wish to transfer your prescriptions to your local Medicine Shoppe pharmacy?

Simply fill out the form below to send a transfer request. We'll take care of the rest!

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Prescription Transfer

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Address

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Provincial Health Insurance Number (facultative)

Transfer From

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Transfer To

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Prescriptions to be transferred

If you choose to transfer only select prescriptions, please provide the drug name or prescription number for each one you'd like to transfer.

Transfer all my prescriptions

Only transfer my selected prescriptions:

Prescription Number or Drug Name

Prefer Brand Name

I consent to sending this information to the pharmacy selected above. Please accept sending information

I understand that some prescriptions cannot be transferred. In that case the pharmacist will contact you. Please accept this

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