TPP Alberta | TPP Prescribers Registration Form

To order a secure pad, please complete and submit the form below.

If you are already registered with TPP Alberta, you do not have to complete this form to re-order pads.

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  • Registrant information

  • 0 of 6 max characters

  • Information for TPP pad

  • If yes, no clinic name, address or phone number will appear on the secure TPP pad.

  • Shipping information

  • If the shipping address is different from the clinic address, please enter a different phone number.

  • Signature

  • We collect and share the personal information in this form for the purposes of registering you in TPP Alberta. We may share your information with the printing and courier vendors for the purpose of producing the secure pads, OR with regulatory organizations as set out in CPSA Bylaws for TPP Alberta. If you have any questions about collecting your information, please contact TPP Alberta at TPP.info@cpsa.ab.ca, 780-969-4939 or toll-free at 1-800-561-3899.
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