Ask Dr. Thomas

St. Albert

#310, 7 St Anne Street
St. Albert AB T8N 2X4


Leduc

#18, 4302-50 Street
Leduc, AB T9E 6J9

Tel: 780.459.5996
Cell: 780.264.5433
Fax: 780.665.6123
Email: info@askdrthomas.com

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Consultation Form

PLACE A ORDER

Welcome to the Pharmacy of Alberta Homeopathic Medical Clinic. Please choose from the following options below. Kindly provide us with all of your shipping and billing details as well as the best time for us to contact you regarding your order. Remember no PAYMENT or CREDIT CARD information is requested OR to be submitted by the user online.

Once your order has been submitted, a representative from the clinic will contact you within 2 hours (during normal business hours) to complete your request and inform you of payment and shipping details. Any questions or concerns about an order can be forwarded to pharmacy@askdrthomas.com

There are two ways to order your prescription medications with askdrthomas.com™. For faster processing and delivery times order on this website. If you are not comfortable shopping on the internet you may also order over the phone. If you are looking for stock availability and pricing please email us directly at pharmacy@askdrthomas.com


* Indicates Required Fields

Address Information

First Name:*
Last Name:*
Address:*
City:*
State/Province:*
Country:*
Zip/Postal Code:*
Phone Number:*
Email Address:*


Informed Consent for Patient Counselling

What time is the best time for you to receive counseling from a pharmacist regarding the use of your medication?


Prescription

Are you sending a NEW prescription or a REFILL request to be processed with this order?


Special Instructions

Preferred method of contact for clarification: Email Telephone  
Preferred method of contact for processing: Email Telephone  
Preferred method for payment: Credit card Cash*
  * Cash payment is only accepted for instore pickups and refills


Refills Requested

* - Fields required to be filled for your request.
  • D.I.N. number: found on the top of the prescription label (only for patients ordering refills)
  • Medication Name:as on label, indicated liquid or pellet form (ex. Arnica pellets)
  • Potency:e.g. 1DH, 6C, 30C, 200CH, 1M, 5M, 10M, etc.
  • Quantity:number of bottles of each remedy
  • Brand:Heel, Boiron, Dolisos, Metagenics, etc.
D.I.N. number: *Medication Name: Potency: *Quantity: Brand:

Please be advised that if the quantity requested does not correspond with our pack sizes, we will fill according to your most recent order, or the closest available pack size.


The order you have just submitted will for processing and cannot be changed or stopped once submitted. Please be sure all information you have provided is accurate. A representative will contact you within 2 hours during regular business hours. Please allow up to 2 days for delivery of your order.

Free shipping on Canadian orders over $100 (excludes shipping address in the USA).

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