New Patient Information Form

We cannot fill your prescription until we have some basic information, click here for the New Patient Information Form.

If the prescription is for an animal please

Click here for a online form to enter your information for your animal that will be emailed to us

 Click here for a printable “New Patient Information Form for Animals” 


 If we are unable to speak to you directly we will be unable to leave messages on your behalf without a permission to do so, also we will not be able to speak to others on your behalf without the information on file,  click here for the Lopez Island Pharmacy Patient Notification Form.



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