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CareConnect Intake Form for Pharmacies

**Google Chrome is recommended for this form**

If you are a physician and would like to complete an Intake Form to enroll your worksite with CareConnect, please go to this form.

Participation to respond to the survey is voluntary and will not directly impact patient care in any way.  This will take about 5 minutes of your time.

The purpose of this survey is to request contact information from participating Pharmacy Managers who are interested to enroll for CareConnect, the Provincial eHealth Viewer.  This survey also includes request for site-related information to facilitate CareConnect enrolment process. If you have previously sent us an email for CareConnect enrolment, you may skip this survey.  

Enrolment is currently open, with limited spots available each month. We are implementing a multi-district enrolment approach. This is to ensure that all pharmacies, in both rural and urban areas, can be slotted for enrolment on a monthly basis. Using the survey responses, we will get in touch with you with the enrolment details once ready to onboard you to CareConnect. 

CareConnect Disclaimer:

PHSA collects, uses and shares Personal Information only in accordance with the BC Freedom of Information and Protection of Privacy Act. All responses will be kept confidential and any reporting will be developed using aggregated and non-identifiable data. For any privacy related questions, please contact
If you have questions about this survey or the implementation of CareConnect in community pharmacies in BC, please contact