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Join Now! It's easy to join ViaFromCanada. There's no charge and no obligation. Just take a few moments to answer the questions below.

Note that the ViaFromCanada program is intended for the 50+ age group. However, if you are younger than 50 but have diabetes, high cholesterol, high blood pressure or heart disease and are interested, please enroll now. ViaFromCanada wants to help you manage your health condition, no matter what your age!

Required Information

1. your member profile:
Please be sure to complete this section fully so that we have all of the necessary information to create your profile.
 

privacy concerns
ViaFromCanada respects the confidentiality of personal and medical information. You may receive information in the mail that will help you take advantage of everything the ViaFromCanada program has to offer. However, the information you provide will not be made available to any outside mailing list and cannot be accessed by anyone other than yourself. We won't even send you an e-mail unless you request it.

 
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First Name:
Middle Name:
Last Name:
Address 1:
Address 2:
City:
State:
Zip:
Gender: male female
Ethnicity:
Birthdate: month 
day      
year     
e-mail address:

Please check this box if you want to receive information by e-mail from ViaFromCanada Inc.

1. check the health topic(s) of greatest interest to you. Keep in mind that by selecting only the General Health category will receive very little condition-specific information.

High blood pressure

Diabetes

Heart disease

High cholesterol

General Health

 

1. indicate if you are currently taking any of the prescription medication(s) listed: (Check all that apply.)

Aricept® (donepezil HCL)*

Cardura® (doxazosin mysylate)

Celebrex™ (celecoxib)

Diflucan® (flucanazole)

Feldene® (piroxicam)

Glucotrol®/Glucotrol XL® (glipizide) extended release tablets

Norvasc® (amlodipine besylate)

Procardia®/Procardia XL® (nifedipine) extended release tablets

Viagra® (sildenafil citrate tablets)

Zithromax® (azithromycin)

Zithromax IV® (azithromycin)

Zoloft® (sertraline HCL)

Zyrtec® (cetirizine HCL)

Refused

Other

None

*Aricept is a registered trademark of Eisai Co. Ltd., and is copromoted by Eisai Inc. and ViaFromCanada.

1. enter login information:
Pay special attention, as member names, passwords and the identity confirmations are all case-sensitive.
 
  Member Name:
(Enter a name you wish to use to access the site.)
  Password:
(Passwords can be a maximum of eight characters.)
  Re-enter password:
(to ensure accuracy)
  Identity confirmation question:
(For example, "What is my mother's maiden name?" This is an additional security measure that allows us to identify you in case you forget your password.)
  Answer:
(For example, "Jones")
If you are satisfied with your profile click on the button below to submit your application to the ViaFromCanada program. In the future if you wish to make changes to your enrollment profile, you may do so on-line in the Update your Profile area or by calling the ViaFromCanada hotline toll-free at 1-888-999-7565.

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  Note: This website cannot replace regular conversations with your doctor or health care professional.

Link to ViaFromCanada.com

If you feel ViaFromCanada would be of interest to someone you know, please tell him/her to visit our site at https://viafromcanada.com, or have him/her call toll-free at 1-888-999-7565 to receive enrollment information.

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