Transfer Prescriptions

Online:

Complete the online request transfer form.
Complete Now
Be Well APP:

Sign-up or login to request a transfer.
Login to Be Well App
In-Person:

Visit or call your local Rexall Pharmacy.
Find a Store

Transfer Prescriptions using Request Form

Complete the form to transfer your prescriptions.

Patient Information

First NameRequired Last NameRequired
Birth DateRequired DD-MM-YYYY

Birthdate Day (DD)

EmailRequired
Phone Number Required

Phone Number

Secondary Phone Number

Secondary Phone Number
AddressRequired City or TownRequired
ProvinceRequired
Postal Code Required A1A 1A1

Transferring Pharmacy Location

Existing PharmacyRequired
Other
Pharmacy Phone Number Required

Sending Pharmacy Area Code

Pharmacy Being Transferred To

Prescription(s) to be Transferred

Please provide us with drug name or prescription number for each of the prescriptions you would
like to transfer to Rexall. Yes, please transfer all of my prescriptions to Rexall
No, I only want certain prescriptions to be transferred.

Prescription 1

Drug Name RX Number
Notes
Fill my prescription as soon as the prescription transfer is complete.
Hold prescription until I request a fill.

Prescription 2

Drug Name RX Number
Notes
Fill my prescription as soon as the prescription transfer is complete.
Hold prescription until I request a fill.

Prescription 3

Drug Name RX Number
Notes
Fill my prescription as soon as the prescription transfer is complete.
Hold prescription until I request a fill.

Important Note

Rexall is committed to protecting the privacy of our customers' information. Any and all information provided on this form will be kept strictly confidential in accordance with our privacy-policy.

By submitting this form you are giving consent for a Rexall representative to contact the transferring pharmacy indicated to complete your prescription transfer request. Prescription transfers occur digitally or via facsimile, and Rexall may use third party service providers to facilitate a prompt transfer.

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Transfer Prescriptions

Online:

Be Well APP:

In-Person:

Transfer Prescriptions using Request Form

Patient Information

Transferring Pharmacy Location

Pharmacy Being Transferred To

Prescription(s) to be Transferred

Important Note

Prescriptions Management

Health Resources Quickfind

Rexall Care Network

Rexall Direct

Careers

Transfer Prescriptions

Online:

Be Well APP:

In-Person:

Transfer Prescriptions using Request Form

Patient Information

Transferring Pharmacy Location

Pharmacy Being Transferred To

Choose a Rexall Pharmacy Location

Prescription(s) to be Transferred

Important Note

Prescriptions Management

Health Resources Quickfind