1150 Franklin Blvd.
Cambridge, ON
519-620-7044

Rx Refill

This form is for PATIENTS ONLY. The cost of this Prescription Refill is not covered by OHIP and costs $20 per prescription. I.e. if you need 3 prescriptions filled, you must fill this form out 3 times. We will get this complete within ONE BUSINESS DAY.

If for any reason we can not fill your prescription using this form, you will be issued a refund. Certain prescriptions and illnesses require that you come in for tests or a chart review.

NOTE: IF YOU ARE REFILLING A PRESCRIPTION FOR A CONTROLLED SUBSTANCE (NARCOTIC) YOU MAY NOT USE THIS FORM. Make an appointment or come to the weekend walk-in clinic.