• New Patient (Animal) Information Form

    We require this basic information to treat your pet.

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  • Lopez Island Pharmacy Patient Notification Options

    Use these options to tell us who is involved in your care, so that we may provide them with the information they need to assist you. We will act upon the information you provide on this form unless your inform us that it has changed. This form does not apply in the hospital setting

  • The individuals listed below are involved in the ongoing care of my pet. Lopez Island Pharmacists and staff may provide them with limited information about my pet's condition and care as needed to assist me.

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  • Other Information

    I am satisfied with the explanation regarding this form that I request and received
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