Alliance Pharmacy
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Prescription Transfer
F.A.Q
Download App Coming soon
Alliance Pharmacy
Home
Parking Rules
Our Story
Our Services
Schedule Booking
Need Help? Contact Us
Our Team
Prescription Transfer
F.A.Q
Download App Coming soon
Prescription Transfer
Are you moving? Do you need to change pharmacy? If you wish to transfer your prescriptions to
Alliance pharmacy
, simply fill out the secure form below to send a transfer request. We'll take care of the rest!
TRANSFER FROM
Pharmacy Name
Pharmacy Phone Number
If you choose to transfer ALL YOUR PRESCRIPTIONS or only SELECT PRESCRIPTIONS, please provide the drug name or prescription number for each one you'd like to transfer.
*
PATIENT INFORMATION
Patient Full Name
*
Birth Date
*
Birth Date
Patient Phone Number
*
Please Attach Drug Plan Details If Available
I consent to sending this information to the pharmacy selected above.
I understand that some prescriptions cannot be transferred. In that case the pharmacist will contact you.
Request Transfer
+1-613-722-2008
+1-343-883-2241
rx@alliancepharmacyrx.ca
1239 Wellington Street W, Ottawa, ON K1Y 3A3, Canada