This page is under Contruction...
Please do not fill in the form until further notice.
Thank you.

Thank you for reordering your prescription with Glebe Pharmasave.

Please note that NEW prescriptions can only be ordered by physicians. RENEWALS can be made by patients via this form. If the number of repeats indicated on your prescription label is "0", we will have to contact the prescribing physician before refilling the prescription.

Prescription renewals received prior to 5pm are usually delivered the same day. Please provide the following information as it appears on your prescription label:

1. Your name as it appears on the prescription label.

2. The prescription (Rx) number

and/or,
3. Name of drug as it appears on the prescription label.

4. A phone number where you can be reached during the day.

5. Address where you want the prescription delivered.

6. Postal Code

7. Your daytime e-mail address

8. If there should arise any problem with filling your prescription,
would you prefer we contact you by:
phone or by email ?

Additional comments


For your safety and security we may from time to time contact you, or your doctor to validate the prescription.