La Crete Apple Drugs Booking

La Crete Apple Drugs
10603 100 St, La Crete, AB

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All your information is kept strictly confidential and 100% secure. For life-threatening emergencies call 911. If you are suffering an acute mental health crisis call 1-833-456-4566.
Is this appointment for you or for your dependent?
Are you a returning patient?
Is your dependent a returning patient?
Patient Information
Patient name

First NameLast Name
Pronouns
Please select "Other" to provide the patient's preferred pronouns
Please enter the preferred pronouns
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Sex assigned at birth
Gender identity
Please select "Other" to provide the patient's preferred gender identity
Please enter the preferred gender identity
Email address
example@example.com
Phone number
Please enter a valid phone number.Format: +1 (000) 000-0000.
Address

Street Address

Street Address Line 2

CityProvince

Postal Code

Caregiver/Guardian Information
What is your name?

First NameLast Name
Pronouns
Please select "Other" to provide your preferred pronouns
Please enter your preferred pronouns
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Email address
example@example.com
Phone number
Please enter your phone number
Please enter a valid phone number.Format: +1 (000) 000-0000.
Address
Please enter your address

Street Address

Street Address Line 2

CityProvince

Postal Code

Placeholder Email
Alberta Health Number

This allows us to offer your appointment for free. If you don't have this handy you can provide it before your appointment.
Do you have a current/valid Alberta Health Card?
Does your dependent have a current/valid Alberta Health Card?
Service date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Is this a new concern or a follow-up appointment?
Would you like us to try and match you with the last Doctor who saw you if he/she is available?
Would you like us to try and match your dependent with the last Doctor who saw your dependent if he/she is available?

What is the main reason you want to see a doctor?
What is the main reason your dependent want to see a doctor?
Please select one of the following medications for a prescription refill.
If you don't see your medication, please select "Other" to type out the name of your medication.
Please type out the name of your medication(s).
Please type out the name of your dependent's medication(s).
Tell us more. Please describe the details for your visit.
Tell us more. Please describe the details for your dependent's visit.
This pharmacy has been installed with medical devices that allow for initial assessment and collection of vital signs when beneficial and clinically relevant to your concern. Is your pharmacy able to assist you with the use of the device?
Blood Pressure ( mmHg )
Temperature ( Celsius )
Heart Rate ( BPM )
O2 Saturation ( % )
Readings from Stethoscope

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Others/File Upload

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Are you a Veteran?
Please enter your Blue Cross ID
Partner Landing Page
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Private Pay Alberta

$75.00 CAD

Total

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Patient Information