Download Order Forms
You can easily order Canada prescription drugs from our Canadian Pharmacy through mail order.
If you have placed an order for prescription drugs through this web site (not through mail order) all that is further required is a valid prescription, if necessary, for your order. Please , or fax the prescription to 1-866-773-2696. Please include your order number (the order number can be found on the confirmation email).
Mail Order Forms
New customers are required to fill out a release form, allergy form and health profile for their first order only. If you have ordered from us before and want to order through the mail you are required to only fill out an order form.
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Order Form (PDF: 170 kb)
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Authorization Form (PDF: 63 kb) (first order only)
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Patient Allergy Form (PDF: 74 kb) (first order only)
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Health Profile Form (PDF: 70 kb) (first order only)
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Adobe Acrobat Reader is needed to view the forms. The free reader can be downloaded here. Reader installation instructions.
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How to Download the Forms
- Click on the form that you need.
- If Adobe Acrobat Reader is installed it will load the form into a new browser window.
- You can then just print the form from the browser.
- If you do not have Adobe Acrobat Reader installed on your computer, you will be prompted to save the file to your computer. Save the file to a location on your computer that you will remember. To view the forms you will need to install Adobe Acrobat Reader.
RxNorth.com
115 Main St. South
Minnedosa, MB
Canada
R0J 1E0
Phone: Toll free 1-888-773-2698
Fax: Toll free 1-866-773-2696, or 204-867-5646
Contact RxNorth Online
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