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MEDICATION LIST Please bring with you on Day of Surgery OR Fax to: 415.567.1181 PATIENT NAME AND PHONE NUMBER: PRIMARY DOCTOR IS NAME AND PHONE NUMBER: PHARMACY AND PHONE NUMBER: Medication Reconciliation
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How to Fill Out Medication List Please Bring:

01
Start by gathering all of the medications you are currently taking. This includes prescription medications, over-the-counter medications, vitamins, supplements, and any herbal remedies.
02
Write down the name of each medication. Be sure to include the brand name (if applicable) and the generic name. If you are unsure of the generic name, you can ask your pharmacist for assistance.
03
Write down the dosage or strength of each medication. This can be found on the medication bottle or packaging. If you are unsure, again, your pharmacist can help provide this information.
04
Include the frequency or schedule in which you take each medication. This includes how often and at what time of day you take each medication. It is important to be as accurate as possible with this information.
05
Write down the reason or condition for which you are taking each medication. This provides important context for healthcare providers who may review your list. It helps them understand the purpose and importance of each medication.
06
Include any allergies or adverse reactions you have had to medications in the past. This is crucial information for healthcare providers to ensure your safety and avoid any potential allergic reactions.
07
Keep your medication list up to date by reviewing and updating it regularly. Whenever there are changes to your medication regimen, such as starting or stopping a medication, be sure to update your list accordingly.

Who Needs Medication List Please Bring:

01
Patients visiting a new healthcare provider. A medication list helps provide an accurate picture of your current medication regimen, ensuring proper diagnosis and treatment.
02
Patients with chronic illnesses or complex medication regimens. Keeping a detailed medication list can help manage multiple medications and avoid potential drug interactions.
03
Patients with allergies or adverse reactions. Providing a medication list that includes this information is vital to prevent any potential allergic reactions or adverse effects.
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A medication list is a comprehensive list of all the medications a person is currently taking, including prescription medications, over-the-counter medications, and supplements.
Patients are usually required to provide their medication list to healthcare providers, especially when seeking medical treatment or consulting with a new healthcare provider.
The medication list should include the name of the medication, dosage, frequency, and the reason for taking the medication. It is important to keep the list updated and accurate.
The purpose of a medication list is to ensure healthcare providers have accurate information about the medications a patient is taking to prevent harmful drug interactions and provide appropriate medical treatment.
The medication list should include the name of the medication, dosage, frequency, and the reason for taking the medication.
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