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Medication Information

How many times has this happened to you? You're filling out a patient form and get to the spot that says "current medications," and there is enough room to list 3, maybe four drugs. That's a problem when you take 12 different medications!

You won't have that problem using our form! There are two full lines to list drug allergies and then room on each page to list 6 medications, dosage, times per day, reason taken and prescribing doctor. You can use as many pages as you need. This is one form we recommend everyone fill out and print several copies. Keep one with you at all times if possible, give one to a spouse or good friend and take an updated list to each and every doctors appointment. This greatly decreases the chance of you being given a drug that can possibly interact with a medication you are already taking.

Like the other forms we've created two different versions of this form. One can be filled out online, just fill in the boxes and print. The other can be printed and filled out by hand.

Tina Underwood
Page last updated on March 11, 2001