Online Prescription (Rx) Forms

To print out a hard copy Space Maintainers Prescription (Rx) form, simply click on your preferred laboratory location below. (For a full laboratory information package, use the convenient Contact Us form or call the telephone numbers listed).

Space Maintainers Laboratories - Canada
Calgary	115 17th Avenue S.W. Calgary, AB T2S 0A1	(403) 228-5120 | TOLL FREE 1-800-661-1169
Edmonton	#400-10113 104th Street Edmonton, AB T5J 1A1	(780) 423-1904 TOLL FREE 1-800-661-2745
Ottawa	1175 Cecil Avenue Ottawa, ON K1H 7Z6	(613) 736-1946 | TOLL FREE 1-800-267-7040
Saskatoon	336 6th Avenue North Saskatoon, SK S7K 2S5	(306) 665-8815 | TOLL FREE 1-800-665-8815
Toronto	40 Pippin Road, Unit 11 & 12, Concord, ON L4K 4M6	(416) 410-1330 | TOLL FREE 1-800-268-4294
Vancouver	936 West 8th Avenue Vancouver, BC V5Z 1E5	(604) 737-2010 | TOLL FREE 1-800-663-1721
Victoria	1928 Oak Bay Avenue Victoria, BC V8R 1C9	(250) 595-2314 | TOLL FREE 1-800-663-6364