Get Started with PrescribeIT^®

PrescribeIT^® is available in a number of communities and we are working actively to scale the service across Canada.

Contact Information

Prefix

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First Name*

This is a required field. Please fill in the appropriate information.

Last Name*

This is a required field. Please fill in the appropriate information.

Language Preference*

Required field.

Clinic Name*

This is a required field. Please fill in the appropriate information.

City/Town*

This is a required field. Please fill in the appropriate information.

Email Address*

This is a required field. Please enter a valid email address.

Which EMR is used in your clinic?*

This is a required field, please provide the appropriate information.

Specify "Other" EMR

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Clinics can be enabled on PrescribeIT once registration information and activities have been completed for prescriber(s).

Do you wish to add prescribers now? (*)
You may add up to five prescribers. Please click "No, please contact me" if you need to add more than five prescribers.

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Prefix

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First Name

This is a required field. Please fill in the appropriate information.

Last Name

This is a required field. Please fill in the appropriate information.

Mobile Number (Required for two-factor authentication.)

This is a required field. Please enter a valid telephone number.

Email Address

Please enter a valid email address.

College License Number

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Prescriber Role

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Specialty

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Specialty

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Prefix

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First Name

This is a required field. Please fill in the appropriate information.

Last Name

This is a required field. Please fill in the appropriate information.

Mobile Number (Required for two-factor authentication.)

This is a required field. Please enter a valid telephone number.

Email Address

Please enter a valid email address.

College License Number

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Prescriber Role

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Specialty

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Specialty

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Prefix

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First Name

This is a required field. Please fill in the appropriate information.

Last Name

This is a required field. Please fill in the appropriate information.

Mobile Number (Required for two-factor authentication.)

This is a required field. Please enter a valid telephone number.

Email Address

Please enter a valid email address.

College License Number

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Prescriber Role

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Specialty

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Specialty

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Prefix

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First Name

This is a required field. Please fill in the appropriate information.

Last Name

This is a required field. Please fill in the appropriate information.

Mobile Number (Required for two-factor authentication.)

This is a required field. Please enter a valid telephone number.

Email Address

Please enter a valid email address.

College License Number

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Prescriber Role

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Specialty

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Specialty

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Prefix

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First Name

This is a required field. Please fill in the appropriate information.

Last Name

This is a required field. Please fill in the appropriate information.

Mobile Number (Required for two-factor authentication.)

This is a required field. Please enter a valid telephone number.

Email Address

Please enter a valid email address.

College License Number

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Prescriber Role

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Specialty

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Specialty

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This is a required field. Please fill in the appropriate information.

We collect and use your information to fulfill the purpose of your interaction with us: to respond to your inquiries, notify you about changes and provide PrescribeIT^® status updates. For more information please refer to our Privacy Policy.

Get Started with PrescribeIT®

Get Started with PrescribeIT^®