Community Health Practitioner PharmaNet Access Agreement

Request to Update Community Health Practitioner and Community Practice Information


* indicates field is mandatory

Practitioner College ID#*
Pharmacy Equivalency Code (PEC)
Practitioner First Name*
Practitioner Middle Name
Practitioner Surname*
Practitioner E-mail Address
Community Practice Name*
Community Practice Street Address*
Community Practice City*
Community Practice Postal Code*
Phone*
Fax
Vendor*

Please update the following information as applicable:

Community E-mail Address
Community Practice Address
Phone
Fax
Vendor

OR:

Cancel Access to PharmaNet at ALL Community Practice Locations
Cancel Access to PharmaNet at Specified Location(s) (please identify below)
Other (please identify below)

Please provide any other relevant information that may assist us with your request


For more information contact: HLTH.HNETConnection@gov.bc.ca


 HLTH 7092 - Last Revised: October 03, 2019