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Prescription Transfer
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Prescription Transfer
Contact
More
Banff Value Drug Mart
Transfer Form
Pharmacy Name*
Pharmacy Phone*
Prescriptions to be Transferred
Transfer all my prescriptions
Only transfer my selected prescriptions
Patient Info
First Name*
Last Name*
Email*
Birth Date*
Phone*
I consent to sending this information to the pharmacy selected above.
I understand that some prescriptions cannot be transferred. In that case pharmacist will contact you.
OR
Contact us by phone at
(403) 760-7082
/ via email at
banffdrugmart@gmail.com
.
Request Transfer
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