Universal Medication Form

Universal Medication Form

Many duplications and complications can be prevented if you take charge of your medications. Recording and updating your medication list will enable effective communication between your doctors and pharmacist about the medications that you are taking.

Just ask! Know your medicines, get it right! Be proactive! Keep a well-maintained “medication list” because it empowers you and serves as a written mode of communication between healthcare providers.

How does this form help you?

  • This form helps you and your family members remember all of the medications you are taking.
  • This form provides your doctor(s) and others with a current list of all your medications. Doctors need to know herbals, vitamins and over-the-counter medications you take.
  • This form helps reveal concerns that may be prevented by knowing what medications you are taking.

Download the form