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My Medication List Name: ___ Date completed: ___ Date of Birth:___ Height: ___ Weight: ___ Preferred Pharmacy: ___ Phone: ___ Allergies: ___ List all prescriptions, overthecounter medicines, vitamins,
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How to fill out my medication list
How to fill out my medication list
01
Gather all your prescription medications, over-the-counter medications, vitamins, and supplements.
02
Make a list including the name of the medication, dosage, how often you take it, and the reason for taking it.
03
Keep the list updated with any changes in your medications, such as starting or stopping a medication.
Who needs my medication list?
01
Your primary care physician
02
Any specialists you see regularly (such as a cardiologist or endocrinologist)
03
In case of emergency, healthcare providers at the hospital or urgent care clinic
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What is my medication list?
Your medication list is a record of all the medications you are currently taking, including prescription drugs, over-the-counter medications, vitamins, and supplements.
Who is required to file my medication list?
Your healthcare provider is usually responsible for keeping track of and filing your medication list.
How to fill out my medication list?
To fill out your medication list, you can provide your healthcare provider with the names of all the medications you are taking, the dosages, and how often you take them.
What is the purpose of my medication list?
The purpose of your medication list is to keep track of all the medications you are taking to ensure that there are no interactions or duplications that could harm your health.
What information must be reported on my medication list?
Your medication list should include the name of each medication, the dosage, frequency of use, and the reason for taking it.
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