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  • Click here for Fax/Mail Order Form.
  • Complete and sign the form and send to Purely Canadian Drugs with a copy of your original prescription(s). Your prescription(s) will be verified by Purely Canadian Drugs with your physician’s office. We also require a copy of one of the following: driver’s license, passport, military ID, or birth certificate.
  • A Healthcare Specialist will contact you to confirm your order.

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