Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Have you had any prescriptions filled at our pharmacy before? *NoYesWould you like to transfer all your medication to main drug mart IDA? *NoYesPharmacy Name *Pharmacy Phone Number *First Name *Last Name *Email *Phone *Date of Birth *Password *PasswordConfirm PasswordAddress Line 1 *Address Line 2 you IDA? Pharmacy City *Province *OntarioPostal Code *Gender *MaleFemaleOtherHealth Card (Including Version Code)Did you use any of there Special Services (Multi Select)Please Select A ServiceCompounding MedicationHome HealthcareCompression StockingLymphedema GarmentIncontinence SolutionsRegistered Holistic NutritionistCertified CosmeticianOtherMedical Condition *Search..NoneAcneInsomniaIron DeficiencyIrritable Bowel Syndrome (IBS)Age SpotsScarAlzheimer's DiseaseLupus (Systemic Lupus Erythematosus)LymphedemaDermatitisAlopecia / Hair LossAsthma / COPD (Chronic obstructive pulmonary disease)Major Depression / AnxietyMelasma (Chloasma)Menopause And PerimenopauseBack Pain / SciaticaAtrial FibrillationMigraineMultiple SclerosisOsteoarthritisOsteoporosisPeptic UlcerCarpal Tunnel SyndromePeripheral Arterial DiseasePre-DiabetesDiabetes type 1Diabetes Type 2Premature EjaculationErectile dysfunctionBenign prostatic Hyperplasia (BPH)Raynaud's PhenomenonRosaceaDiabetic NeuropathiesNeuropathic PainHigh Blood Pressure (Hypertension)High Cholesterol (Hypercholesterolemia)CVS (cardiovascular disease)FibromyalgiaStroke or TIA (Transient ischemic attach)Gastroesophageal Reflux Disease (GERD)Urinary IncontinenceVaricose VeinsHemorrhoids / anal fissureHypo/Hyper thyrodismOverweight / ObesityCancerNail fungus (onychomycosis)Rheumatoid ArthritisAthlete's foot (tinea pedis)Atrial fibrillationDementiaHigh cholesterolMacular degenerationSubstance use disordersOtherOther Medical Condition *Consent *I AgreeBy selecting “I Agree,” I confirm that I have read and understood this consent form and agree to the terms outlinedRegister