Switch to PharmaSense

We’re delighted to have you as a client at PharmaSense!!

Complete the form on this page with your contact information plus the name and address of your current pharmacy. We’ll get in touch with them directly and transfer your prescriptions to PharmaSense. We’ll call you to confirm the transfer (it usually takes 1-2 business days) and let you know when your prescriptions are ready for pickup.

If you’d prefer delivery, please let us know! We offer free delivery throughout Oakville and Mississauga for all prescription purchases of $30 and more.

Download our app! It’s free, easy to use, and so convenient when you want to request a refill. Get the app now.

Prescription Transfer Request Form

Name

First Name

Last Name

Cell Phone

(###)

###

####

Current Pharmacy Info

Current Pharmacy Name

Pharmacy Location

Enter the address or Intersection of the Pharmacy you are currently at.

Current Pharmacy Phone Number

If you have it, please enter the phone number of your current pharmacy.

Prescription Info

Prescription 1

Enter the name of the medication you would like to fill

Prescription 2

Enter the name of the medication you would like filled

Prescription 3

Enter the name of the medication you would like to fill

Prescription 4

Enter the name of the medication you would like to fill

Additional Prescriptions

Please enter any additional prescriptions here, 1 per line.

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