450-978-9736 | info@ejmpharma.ca

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Order Form

Step 1: Select your products

Product Quantity

If the product you are looking for is not in the scrolling choices, please enter it manually.

Step 2: Prescription information if necessary


If the compounded solution is for a patient, join a copy of the prescription. Make sure to black out personal informations for a confidential transmission.


For a renewal, enter the prescription number of our EJM pharmacy if you have it on hand.

Insurance and Delivery

The RAMQ pays the cost of transport of covered preparations from the compounding pharmacy to the dispensing pharmacy for the patients covered under this regime. If applicable, please check RAMQ and enter the prescription number at your pharmacy. If the product is for multiple patients, only one prescription number is sufficient.

Step 3: Your informations

A confirmation of your order or estimation will be sent in the email above.