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Medical Profile Form

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Submit your registration and prescriptions online via our online medical form.

Download and Print

Download and print our medical form, then fax to 1-800-475-2144 or mail to Canadian Meds, P.O. Box 121093, West Melbourne, FL 32912.

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Have questions? We’re just a call, click, or visit away.

1600 Sarno Road, Suite 113 Melbourne FL 32901, United States
(321) 574-6976
Correspondence only: P.O. Box 121093, West Melbourne, FL 32912, United States
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