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Pharmacy Application of Interest

Interested in learning more about PrescribeITTM?

At the present time, the service is only available in select communities as we prepare the PrescribeITTM technology for larger scale rollout starting in 2018. To help us plan our deployment, please complete this form:

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Contact Information:

Prefix:
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First name:(*)
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Last name:(*)
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Pharmacy name(*)
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Pharmacy Type(*)
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Address:(*)
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City/Town:(*)
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Province / Territory(*)
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Postal Code(*)
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Telephone Number:(*)
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Email Address:(*)
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Pharmacy Information:

Number of prescriptions dispensed daily:
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We dispense methadone:(*)
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Which pharmacy management system does your pharmacy use?(*)
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specify "Other" PMS:
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How are the majority of your patients’ prescriptions delivered to your pharmacy?(*)
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Is there any other information you would like to share with us?
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