Forms and Login


Looking for an easy way to send us information about a new resident at your facility? You can either fill out the online form, or download the forms and fax them to us.

Secure Online Login

From the Kelley-Ross web portal, you can access information about your patient’s current medications, reorder meds, print MARs and Physician Order Sheets.

  • Patient Information

  • MM slash DD slash YYYY
  • Insurance Information

  • Contact Information

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  • (please separate multiple conditions with commas)
  • (enter 'None' if appropriate)
  • (for Medicare and Medicard enrollment)
  • Feel free to make comments.

Kelley-Ross is an independently owned corporation operating 4 pharmacies in Seattle. Kelley-Ross provides a wide range of pharmacy services, including prescription dispensing, compounding, medi-set packaging, compliance packaging, long-term care facility services, consultant pharmacist services, immunizations and a variety of health screenings.

We provide Clinical Community Care. This means that our staff combines expert medication therapy management and clinical skills, with caring, patient centered pharmacy services. By using the triad approach – patient, provider and pharmacist – we can help patients maximize their healthcare resources while achieving optimal health outcomes.

Our high service level and commitment to problem solving has made Kelley-Ross the pharmacy of choice for patients and providers across the Northwest.