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Prescription Refill Appointment

Processed within 2 hours Up to 3 medications No controlled drugs

Form progress may be saved securely so our team can help if you do not finish this request. Card details are never collected on this form.

Prescription Refill Appointment

Prescription requests are processed within 2 hours after your appointment. Please provide accurate medication details and required proof.

Working hours: 9:00 AM-5:00 PM. Refunds: A $20 fee is deducted for administration and payment gateway charges.

Patient Details

First Name Last Name Phone Please enter a valid phone number. Format: (000) 000-0000. Email Street Address City State / Province Postal / Zip Code Date of Birth

Alberta Health Card

Do you have an active Alberta Health Card (PHN)?

Active Alberta Health Card holders get prescription refills free. Without one, the fee is $50.00 CAD.

Refill Details

Reason for Prescription Refill 0/150 We do not refill controlled medications. The doctor may request a photo of the medication label, bottle, or prescription snapshot for verification. Proof of current medication use Upload a bottle snapshot, medication label, prescription snapshot, or other proof of current use.

We do not refill controlled drugs. Please provide accurate medication details and required proof so staff can process your request quickly.

Medication Refill Fee

$50 for up to 3 medications

Total $50.00 CAD

Prescription Refill

Request and receive your official prescription refill after your appointment.

$50.00 CAD

Payment Method

Square secure checkout

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