Prescription Refill Request Form

Prescription Refill Request Form

Personal Information


Medication Details


Additional Information


Consent


I,, hereby request a refill of the prescription(s) listed above. I confirm that the
information provided is accurate to the best of my knowledge.

JUST  WALK-IN | MEDICAL CLINIC

Business Hours

Open 7-Days a week, 10:00 am to 6:00 pm

Phone Number & Our Locations

Scarborough Clinic

501 Pharmacy Ave, Scarborough, ON, Canada

📞+1 647-847-6262

📞+1 416-646-0830

📠Fax: 647-748-0830

St. Clair West (Toronto)

942 St Clair Ave West, Toronto, ON, Canada

📞+1 437-2954-280

📞+1 437-2954-033

📠Fax: 437-295-4521

Ruth Ave (Brampton)

27 Ruth Ave, Brampton, ON, Canada

📞+1 905-5022-180

📠Fax: 289-406-1700

Gateway (Brampton)

25 Gateway, Brampton, ON, Canada

📞+1 905-5022-180

📠Fax: 289-406-1700

East York (The Market Place)

5 the Mkt PI, East York, ON

📞+1 437-8261-174

📠Fax: 647-748-0830

 

 

 

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Just Walk-In Clinic