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YOU AND YOUR MEDICATION: HOW EASY IS IT TO ACCEPT? Name of medication taken by the patient (to be completed by the pharmacist): Before filling in this questionnaire, please give today's date:/ / /
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How to fill out you and your medication

01
Start by gathering all your prescribed medications in one place.
02
Read the labels and instructions for each medication carefully.
03
Use a pill organizer to sort your medications by day and time if necessary.
04
Take note of any special instructions such as whether the medication should be taken with food or on an empty stomach.
05
Follow the dosage instructions provided by your healthcare provider.
06
If you have any questions or are unsure about how to take a medication, consult your pharmacist or healthcare provider.
07
Take your medications as prescribed and at the designated times.
08
If you miss a dose, follow the instructions provided with the medication or consult your healthcare provider.
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Store your medications properly, following the specific storage instructions for each medication.
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Dispose of any expired or unused medications safely according to the guidelines provided by your local pharmacy or healthcare facility.

Who needs you and your medication?

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Anyone who has been prescribed medication by a healthcare provider needs to fill out 'you and your medication'.
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By following proper medication management procedures, individuals can ensure the safe and effective use of their prescribed medications.
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You and your medication refers to the information regarding the medication that an individual is currently taking.
Individuals who are under medical treatment or taking prescribed medication are required to file You and Your Medication form.
You can fill out You and Your Medication form by providing details of the medications you are currently taking, including the name, dosage, frequency, and the prescribing doctor's information.
The purpose of You and Your Medication form is to provide accurate information about the medications an individual is taking for medical purposes.
The information that must be reported on You and Your Medication form includes the name of medications, dosage, frequency, and the prescribing doctor's information.
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