Skip to content
Special Announcement August 11, 2018

Lopez Island Pharmacy

Lopez Island Pharmacy

  • Home:
  • Where we’re at:
  • Forms:
  • Weather:
  • Insurance Information We Need:
  • Online New Patient Form-Fill In:
  • New Patient Information Form:
  • Can I return the medication:
  • Screening Questionnaires for All Vaccinations:
  • New Prescriptions and Transfers of Prescriptions from other Pharmacies:
  • How to order a refill of a prescription we have filled for you before:
  • Health Care on Lopez Island:
  • Helpful information on using our pharmacy:
  • Prescription Drug Insurance-Things you need to know:

Website Breadcrumbs

Home
Screening Questionnaires for All Vaccinations

Screening Questionnaires for All Vaccinations

Use this form for Influenza Only:  Patient Informed Consent Form for Influenza(WEB) MASTER

Use this form for all other vaccinations, i.e. not to be used for Influenza(Flu) vaccinations

Vaccination Consent Form(Not for Influenza) rev:09/14/2015

Share this:

  • Twitter
  • Facebook
  • Google

Like this:

Like Loading...

RSS Healthcare News

  • First Brand Named in Turkey Salmonella Outbreak November 16, 2018
    The U.S. Department of Agriculture and other regulatory agencies have not released the names of any other companies involved.
  • 'Huffing' Deodorant Cost One Teen His Life November 16, 2018
    To highlight the continued dangers of huffing, Dutch physicians outline the tragic case of a 19-year-old who died after inhaling spray deodorant to get high.
  • CDC: 1 in 5 U.S. High School Students Now Vapes November 15, 2018
    Between 2011 and 2018, the number of high school teens who started vaping, as e-cigarette use is called, increased from 220,000 (1.5 percent) to just over 3 million (20.8 percent), according to the U.S. Centers for Disease Control and Prevention.
  • Tick-Borne Diseases Set U.S. Record in 2017 November 15, 2018
    The 2017 increase mirrors a rise in tick-borne diseases reported in the United States. Between 2004 and 2016, the number of cases doubled, and researchers discovered seven new tick-borne disease-causing germs.
  • FDA to Limit Flavored E-Cigarettes, Ban Menthol November 15, 2018
    The U.S. Food and Drug Administration said Thursday that it will limit or ban access to flavored e-cigarettes, menthol cigarettes and flavored cigars.
Powered by WordPress.com.
%d bloggers like this: