Submit A New Prescription | Mettra Pharmacy

Mettra Pharmacy New Rx Fill Request

By filling out this form, you are giving us consent to collect, access, and use your personal information which will allow us to process your prescription refills.

First name

Last name

Date of Bith

Contact Number

Email Address

Please Upload a Photo of Your Rx

Upload File

How Would You Like to Get Your Prescription?

Pick-up

Delivery

Pick-up Instructions

Please pick up your prescription at METTRA PHARMACY Unit#105 - 15 Canada Ave, Duncan, BC V9L 1T3.

Monday to Friday 8:00AM - 4:30PM

IMPORTANT: The original prescription must be presented at the pharmacy

Select Time And Date of Pick-up *

Pickup Date

Pickup Time

*PLEASE NOTE. We will contact you to discuss time of delivery and other details

Delivery Address:

Additional Information

Thanks for submitting!