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Order Forms

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Below you can download the forms required to complete your order with ShipRx (Canada).  If you have not ordered from us before please visit our FAQs section for further information.

Please print your forms, complete the information required, then fax them to our TOLL-FREE FAX number 1-888-982-3781.  This will get your order process started.  A customer service representative will follow-up on your order.

 

All original documents can also be mailed or couriered to:

ShipRx / Malterra c/o
601-180 King Street
Winnipeg, Manitoba, Canada, R3B 3G8

 

Please give us a call Toll-Free Telephone number at 1-888-248-5962 if you have any questions, or need assistance with placing your order.

Ordering Forms...

• New Client Forms
• Refill Prescription Form
  

The FDA, due to the current state of their regulations, has taken the position that virtually all shipments of prescription drugs imported from a Canadian pharmacy by a U.S. consumer will violate the law.