Forms & Helpful Papers

Please find our downloadable forms and helpful papers below for your convienience.

Feel free to fax us your filled out forms at our fax number: (408) 847-7878

Medication Disposal Card

Print this card to keep as a reminder of how to dispose of un-needed or expired medication.

Tarjeta de Eliminación de Medicamentos

Imprima esta tarjeta para mantenerla como un recordatorio de cómo deshacerse de los medicamentos no necesarios o vencidos.

Drug Return Credit Sheet

Download and fill out this form to return medications.

HIPAA Client Form

Under HIPAA regulations, Patients have the right to request that this pharmacy restricts how protected health information about you is used or disclosed for treatment, payment or health care operations. Download and print this form to give consent.

Identification & Guarantor Information Sheet

Download, fill out and return this form so we have your information for our records.

How To Use On Call LLC

Download and print this helpful paper to learn how to use the 24/7 Emergency Service with On Call, LLC.

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South Valley Pharmacy Services