Skip to content
Menu
Home
Services
Prescribed Medication
Minor Ailments Treatment
Covid-19 Treatment
Public PCR Test
Vaccination & Immunization
Additional Services
Clinics
Medical Clinic
Travel Clinic
Weight Loss Clinic
Contact
Stay in the loop
prescription transfer / refill
Stay in the loop
prescription transfer / refill
Antigen Test Application
Rapid Antigen Test
Rapid Antigen
First & Last Name
*
Gender
*
Female
Male
Prefer not to answer
Date Of Birth
*
Phone
*
Email
*
Identification Type
*
Health Card
Driver's Licence
Passport
Ontario ID
Other
Other
ID Number
*
How do you want to receive your test result?
*
I consent to receive my test result by email
I choose to get a print at Ultima Pharmacy
reCAPTCHA
If you are human, leave this field blank.
Submit
Home
Services
Prescribed Medication
Minor Ailments Treatment
Covid-19 Treatment
Public PCR Test
Vaccination & Immunization
Additional Services
Clinics
Medical Clinic
Travel Clinic
Weight Loss Clinic
Contact