MB Service and Supply Request | Medications Return Program

A courier vehicle will be dispatched to perform the pickup at your location within 10 business days. If requested, supplies will be delivered at this time.
The courier may require you to place a label with your location's name and address on the containers and boxes before accepting them.
A minimum of two (2) items is required to schedule a pickup. Containers must be full before requesting a pickup (no more than 23kg per container).
Please keep a copy of the automated email receipt and the associated courier receipt on file at your location.

Pharmacy Information

Pharmacy Name *

HPSA ID *

Make sure the information below matches the pharmacy's shipping information.

Address *

City *

Province *

Postal Code *

Requester's Information

Requester's Name *

Requester's Title *

Phone Number *

Email *

Program Criteria

1) Can you confirm that only consumer returns of medications have been deposited in HPSA program containers? *

Yes

2) Can you confirm that there are no free liquids or medical sharps in the medications return container? Please note that all liquid and cream medications must be placed in their original bottle or tube. *

Yes

3) Has the lid on medications return container been properly closed and secured? *

Yes

New Supply Order

Indicate the number of items to be delivered.

Medications Return Container

Pick-up Request

Indicate the number of items to be picked-up.

Medications Return Container

Please provide us any additional requests, comments or questions:

Comments: