Congratulations! As a Medavie Member, you have the option to complete this registration form to receive a Lawtons Drugs Partner Discount Card as well as a "Plus 1 Card". Plus 1 Card applies to a spouse/partner/common law partner.

All fields marked with an asterisk(*) are required.

Preferred Language for Communication *
Employee First Name *
Employee Last Name *
Employer/Plan Sponsor Name *
Medavie Policy Number *
Medavie ID Number *
Street Address/P.O. Box*
Postal Code*

Is this a replacement card?

First Name of Plus 1
Last Name of Plus 1

To receive special offers and promotions targeted specifically to you, enter email below:

Your Email Address
Confirm Your Email
Plus 1 Email Address
Confirm Plus 1 Email

Authorizations and Declarations

I, for myself and on behalf of my partner, and being duly and specifically authorized to do so, authorize Lawton's Drug Stores Limited, its agents and service providers to use and exchange information as needed to administer this loyalty card and to provide information about services and offers which Lawtons believes will be of interest to me.

I understand that by checking off the box below, I am consenting to the collection and use by the Lawton's Drug Stores Limited ("Lawtons Drugs") of personal information about me that is required to maintain an eligibility file, to provide information about services and offers which Lawtons Drugs believes will interest me and to provide benefits of the Lawtons Drugs Partner Discount Card Program, where applicable.

I understand that I may withdraw my consent at any time by delivering a written notice to Lawtons Drugs by hand or by registered mail and in doing so I am no longer able to take advantage of the benefits associated with Lawtons Drugs' loyalty card.

I understand that the Lawtons Drugs' Privacy Policy is available at any time for my review.

I confirm that I have read and understood the content of these terms and conditions or that it has been read or translated for me.

I have read and agree to all of the Terms & Conditions and the Privacy Policy.

Please ensure all information is accurate. Once you submit, there will not be an opportunity to make changes or edits.

For technical issues with this form, please contact