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Online prescription refill

Refill or Transfer Your Prescription at Brantford Medical Pharmacy

If you can't make it to our Brantford pharmacy, you can also transfer or refill your p rescription online using our electronic order form. Fill in the requested fields with your information, and we'll contact you to confirm when your prescription is ready for delivery or pickup. You may also telephone us to speak with a pharmacist over the phone.

Refill Your Prescription

Name*

Phone*

Email

Medication*

Specify*

Delivery or Pick up

Date

Delivery address

Instructions

Thank you! Your message has been successfully sent. We will contact you very soon!

Transfer Your Prescription

Name*

Phone*

Email

Pharmacy Name*

Pharmacy Phone*

Medication*

Specify*

Pick up or Delivery

Date

Delivery address

Instructions

Thank you! Your message has been successfully sent. We will contact you very soon!

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