Required fields are marked with asterisks (*)

STI Medication Ordering Form

Fill out the following form to order free STI medication for your patients. Ordering these medications in advance helps ensure your clinic remains well stocked and supports timely access to care. Please allow up to 7 business days for processing. You will be notified by email when your order is ready for pick-up at your selected location. If your request is urgent, call the Sexual Health clinic at 705-474-1400 ext. 5289 to confirm medication availability and discuss options for expedited pick-up.

Name of Medical Clinic, Health Centre or Hospital:

Name of Ordering Physician or Nurse Practitioner:

Phone number:

Email:

Fax Number:

Address:

City: