Solutions Clinical Pharmacy

Refill Request Form

  • An online prescription refill request can only be completed if the prescription has previously been filled by a member of our Solution’s Clinical Pharmacy team.
  • Please ensure all information is entered correctly and prescriptions match the last name provided in the refill request form.
  • Prescription refill requests will be filled during business hours so please allow 24 hours for our staff to receive and fill your request.
  •  In some cases, refills must be handled directly by the pharmacist at our location and will not be eligible for an online refill.
  • In addition to any regulatory restrictions that may apply, pharmacists reserve the right to refuse refills at their professional discretion and under the direction of Provincial College of Pharmacist Professional Practice Policies, prescriber authority, and Provincial/Federal Legislation.

"*" indicates required fields

Full Name:
As it appears on your Alberta Health Care.
MM slash DD slash YYYY
Address*
At which location would you like to pick up your prescription?*
Please do not include any personal health or billing/credit information. All personal healthcare and payment information will be handled in the store in accordance with our Privacy Agreement.
Consent*