New Patient

Let's Make This Easy

Thank you for choosing SoWal Health & Drug as your partner in health. To sign up as a new pharmacy customer, simply provide the required information below. Any and all information you provide here will be kept strictly confidential.

New Patient Form

Please enable JavaScript in your browser to complete this form.
Name
Address
EZ Open Caps?
Refill Maintenance Medications?
Drug Allergy?

Medication History