February 27, 2013 admin

Order Medication/Refills

PLACE AN ORDER

 

Welcome to the Pharmacy of Alberta Homeopathic Medical Clinic. Please choose from the following options below. Kindly provide us with all of your shipping and billing details as well as the best time for us to contact you regarding your order. Remember no PAYMENT or CREDIT CARD information is requested OR to be submitted by the user online.

Once your order has been submitted, a representative from the clinic will contact you within 2 hours (during normal business hours) to complete your request and inform you of payment and shipping details. Any questions or concerns about an order can be forwarded to info@askdrthomas.com

There are two ways to order your prescription medications with askdrthomas.com™. For faster processing and delivery times order on this website. If you are not comfortable shopping on the internet you may also order over the phone. If you are looking for stock availability and pricing please email us directly at info@askdrthomas.com

 
* Indicates Required Fields

    First Name:*

    Last Name:*

    Address:*

    City:*

    State/Province:*

    Country:*

    Zip/Postal Code:*

    Phone Number:*

    Email Address:*

    Informed Consent for Patient Counselling

    What time is the best time for you to receive counseling from a pharmacist regarding the use of your medication?

    Prescription

    Are you sending a NEW prescription
    to be processed with this order?or a REFILL request

    Special Instructions

    Preferred method of contact for clarification:

    EmailTelephone

     

    Preferred method of contact for processing:

    EmailTelephone 

    Preferred method for payment:

    Credit cardCash

     

    * Cash payment is only accepted for instore pickups and refills

    Refills Requested

    * - Fields required to be filled for your request.

    • D.I.N. number: found on the top of the prescription label (only for patients ordering refills)

    • Medication Name:as on label, indicated liquid or pellet form (ex. Arnica pellets)

    • Potency:e.g. 1DH, 6C, 30C, 200CH, 1M, 5M, 10M, etc.

    • Quantity:number of bottles of each remedy

    • Brand:Heel, Boiron, Dolisos, Metagenics, etc.

    D.I.N.number:

    *Medication Name:

    Potency:

    *Quantity:

    Brand:

    Please be advised that if the quantity requested does not correspond with our pack sizes, we will fill according to your most recent order, or the closest available pack size.

    The order you have just submitted will for processing and cannot be changed or stopped once submitted. Please be sure all information you have provided is accurate. A representative will contact you within 2 hours during regular business hours. Please allow up to 2 days for delivery of your order.

    Please read and click the disclaimer before sending*
     Disclaimer

    metagenics       boiron       heel       sisu       drop       seroyal