Staff Prescription Transfer Form

iCcare Pharmacy - Staff Prescription Transfer

Benefits of transferring your prescriptions to iCcare Pharmacy

Open Monday to Friday from 9 am – 5 pm
Located conveniently on 2nd Floor of Sault Area Hospital across from ADCP off main lobby
Free deliveries to local addresses in Sault Ste. Marie
20% off over the counter items every Wednesday for staff members (show your ID badge when purchasing)

iCcare Pharmacy - Staff Prescription Transfer Form

SAH Workers – To transfer your prescriptions to the iCcare Pharmacy complete the following form.

Contact Us

Instructions

I would like my prescriptions transferred to the iCcare Pharmacy

Employee Name(Required)

First Last

Date of Birth (YEAR/MM/DD)(Required)

Phone(Required)

Extension

Name of Current Pharmacy

Include additional family members below:

First Additional Family Member

First Last

First - Date of Birth (YEAR/MM/DD)

Second Additional Family Member

First Last

Second - Date of Birth (YEAR/MM/DD)

Third Additional Family Member

First Last

Third - Date of Birth (YEAR/MM/DD)

Fourth Additional Family Member

First Last

Fourth - Date of Birth (YEAR/MM/DD)

Fifth Additional Family Member

First Last

Fifth - Date of Birth (YEAR/MM/DD)

This field is for validation purposes and should be left unchanged.

All prescriptions will be put on file when transferred. Please contact us directly for any prescriptions you need filled at 705-256-3467 (or ext 3467) or our confidential email retailpharmacy@sah.on.ca. Please give us 24 hours notice when possible.

iCcare Pharmacy - Staff Prescription Transfer

iCcare Pharmacy - Staff Prescription Transfer Form​

SAH Workers – To transfer your prescriptions to the iCcare Pharmacy complete the following form.

Contact Us

Include additional family members below:

iCcare Pharmacy - Staff Prescription Transfer Form