Prescription refill

Kindly fill out the form below to refill or transfer your prescription. For new prescriptions, kindly attach a copy and bring in the original.

We accept faxed prescriptions from  the  doctor’s office on most prescriptions. Our fax number is 778-477-3812. We can also be reached by phone on 778-477-3811.

 Thanks and see you soon!

First name:*

Last name:*

Phone number:*

Email:

Request type

Refill
Transfer
New prescription

Prescription number(s) or name of medication(s) [can be found on old prescription label]:*

For transfers, name of pharmacy & phone number (if known)

Attach new prescription (remember to bring in original):

Acceptable file types: doc,docx,pdf,txt,gif,jpg,jpeg,png.
Maximum file size: 3mb.

Pick up time:*

Later today
Next day
Later than tomorrow

Extra instructions:

Copy into box below*

Leave this field empty