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Get Started with PrescribeIT®

PrescribeIT® is available in a number of communities and we are working actively to scale the service across Canada.

Contact Information
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First Name*
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Last Name*
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Language Preference*
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Pharmacy Name*
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Unit Number
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Street Number*
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Street Name*
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City/Town*
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Province/Territory*
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Postal Code*
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Telephone Number*
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Fax number (used to receive prescriptions)*
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Email Address*
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Pharmacy Information
Pharmacy License/Accreditation Number
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Pharmacy Management System*
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Specify "Other" PMS
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Owner First Name
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Owner Last Name
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Owner Email Address
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Licensee/Designated Mgr. First Name
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Licensee/Designated Mgr. Last Name
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Licensee/Designated Mgr. Email Address
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Pharmacy Type*
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Practice Type (select all that apply)*
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How are the majority of your patients’ prescriptions delivered to your pharmacy?*
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Is there any other information you would like to share with us?
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We collect and use your information to fulfill the purpose of your interaction with us: to respond to your inquiries, notify you about changes and provide PrescribeIT® status updates. For more information please refer to our Privacy Policy.

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