Transfer

Moving a file from another pharmacy — Shoppers, a hospital, a hometown store. We call them. You don’t have to.

Transfer to

Other pharmacy name (optional)

Other pharmacy phone

First name

Last name

Birthday

Any drug allergy

Coverage

Student plan, private insurance, or UWO staff insurance.

Your phone

Rx numbers or drug names

Contact email (optional)

Fill or hold prescriptions

When it’s ready

Notes

Payment arranged with your pharmacy

Your pharmacy will confirm any amount due and how to pay when your request is ready.

No card details are collected here. Please do not include card numbers or security codes in notes or photos.

We will review this before it’s filled. I agree to the privacy notice and counselling terms.