VTE Antithrombotic Therapy Requisition - MEDICINE HAT
Phone: (403) 528-2111 Fax: 403-526 0655
This service is available 24 hours. If submitting after store hours, confirm receipt of requisition by calling Dan at 403-504-9778.
Complete our online form and we will provide treatment for your patient. All data is encrypted and highly secure. Furthermore, we will collect identifiers when the patient contacts us.
If you prefer, you can scroll down for the pdf version which you can print, fill out, and fax to the pharmacy.