PRESCRIPTION TRANSFER

Are you new to the Coast or have you lost your prescriptions while travelling here?

Simply fill out the prescription transfer form below. We’ll take care of the rest.

Please note: All transfer requests will be handled on the next business day. For urgent pick-ups or deliveries, please call us; 604-886-3365.

    Patient Information

    Your First Name (required)
    Your Last Name (required)
    Your Care Card Number (PHN) (required)
    Your Date of Birth (required)

    Contact Information

    Your Email (required)
    Your phone number (required)
    Street Address (required)
    City (required)
    Province (required)
    Postal Code (required)

    Transfer Location

    Transferring fromTransferring to
    Pharmacy Name (required)
    Pharmacy phone number (required)

    Prescriptions to Transfer

    If you choose to transfer only select prescriptions, please provide the drug name or prescription number for each prescription you’d like to transfer.

    Yes! Since I have 5 or more prescriptions, I would like to speak to a pharmacist about the benefits of using blister packs or strip packaging for my medication. (optional)

    Anti-Spam Check (Required)

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