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Insurance Companies, Union Groups and Fraternal Orders

Our Canadian pharmacy affiliate network is capable of facilitating the large volume and administration that accompanies dealing with a large group. If you are connected with a Union, TPA, PBM, HMO, or Insurance Company, complete the affiliate request form and a representative will contact you about providing your group a cost saving solution for prescription drug fulfillment.


Which Group Do
You Belong To:

Name of your
company or group:

Contact Person:

Street:

City:

State:

ZIP Code:

Phone:

Fax:

E-Mail:

Website Address:

Are you currently with a Canadian Pharmacy?

yes  no

Do you have a call center?

yes  no

Approximate number of lives you represent?

Additional Comments:

  
which plan is best for you?

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