Purchase Orders

You can order or request a price estimate by fax or online. If by fax, please select and print the form according to the branch you would like to be served

To speed up your order, please identify your patient’s name, the RAMQ number if insured and attach the medical prescription

Please allow up to 24-48 hours for delivery.

Fax : 514-342-4996

(Download form)

Fax : 450-663-2568

(Download form)

  • Purchase Order

  • You can place an order or request a price estimate
  • Select the branch you want to be serve from
  • Your information

  • Product selection

  • ProductsFormatConcentration or forceQuantity 
  • Prescription information

  • Please attach a copy of the prescription
    Accepted file types: jpg, jpeg, png, pdf, doc, docx, txt.
  • prescription number of our pharmacy
  • Delivery Options

  • Message or additional information