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Order Form

If you would prefer not to order online at Jandrugs.com, you can simply fill out our Order Form and fax us your information.

Please note: It is not necessary to download and complete this form if you have already placed an order online.

Order Form (.pdf format)

Orden de Compra (en español) (.pdf format)

Prescription Transfers

If you will be transferring your prescription from another pharmacy please fill out our Rx Transfer Form and fax it to us.

Rx Transfer Form (.pdf format)

Pet Medications/Order Form

Very similar to our "Patient Questionnaire" but for your pet's medications. Just fill in your pet's information and fax it to us.

Pet Med Order Form (.pdf format)


You will need Adobe Reader to view and print these forms. If you do not have Adobe Reader you may download a copy here.


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Valid Member
11/20/09

Status Active
11/20/09
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Jan Pharmacy
250-530 Kenaston Blvd.
Winnipeg MB  R3N 1Z4
Canada

1-866-395-DRUG (3784) (toll free)
1-866-412-DRUG (3784) (toll free fax)

1-647-426-7039 (local or outside North America phone)
1-204-928-2039 (local or outside North America fax)

© Copyright 2008, Jan Pharmacy

All Canadian prescriptions are filled by Jan Pharmacy, licensed by the Manitoba Pharmaceutical Association, License # 32476