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Bend Surgical Associates Michael J. Strangely, MD, FACS PATIENT NAME: DATE OF BIRTH: MEDICATIONS Please list all of your current prescription, nonprescription medications, vitamins, minerals, and
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How to fill out medications, please list all:

01
Start by gathering all necessary information, including the name of the medication, dosage instructions, and any specific instructions from the healthcare provider.
02
Ensure you have the prescribed medication and the appropriate tools, such as a pill organizer or syringe, as needed.
03
Read the medication label carefully, paying attention to dosage instructions, frequency of administration, and any additional precautions or warnings.
04
If the medication requires a prescription, ensure you have the correct prescription information and follow the instructions provided by your healthcare provider or pharmacist.
05
Take note of any specific instructions regarding food or drink restrictions before or after taking the medication.
06
Follow the proper administration method for the medication, whether it is to be taken orally, applied topically, or injected.
07
If the medication requires measuring, use a proper measuring tool to ensure accurate dosing. This can include a syringe, measuring cup, or dropper.
08
Keep track of the medication administration by marking it on a schedule or in a medication journal, noting the date, time, and any observed side effects or reactions.
09
Store the medication in a cool, dry place, away from direct sunlight, and out of reach of children or pets.
10
Always consult your healthcare provider or pharmacist if you have any questions or concerns regarding the medication or its administration.

Who needs medications, please list all:

01
Individuals with chronic medical conditions, such as hypertension, diabetes, or asthma, who require daily medication management.
02
Patients recovering from surgery or undergoing specific treatments that require temporary medication use.
03
Individuals with mental health conditions, such as depression or anxiety, who may require medication as part of their treatment plan.
04
Elderly individuals who may have multiple chronic conditions and require medication management.
05
Children or infants with specific medical conditions that require medication for treatment.
06
Individuals with acute illnesses, such as infections, who may require short-term medication use.
07
Individuals with allergies or allergic reactions that require medication, such as epinephrine for severe allergic reactions.
08
Individuals with hormonal imbalances or deficiencies that may require hormone replacement therapy.
09
Patients with pain management needs that may require medication for relief.
10
Individuals undergoing chemotherapy or other cancer treatments that require supportive medications.
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