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Medication List Printer Friendly Version Printer Friendly Version Share

Doctor holding thingIdentifying the most accurate list of medications a patient is taking can be a matter of life and death. Medication reconciliation requires comparing a patient's existing medications with those physicians might order during admission, transfer or discharge. The key to the reconciliation process is an accurate Universal Medication Form carried by the patient.

Download Form My List Of Medications

By using this form you can reduce confusion and save time. You do not have to remember all the medications you are taking. Using this form will also improve communication by providing doctors and health care providers with a current list of ALL of your medications. This will help to improve medication safety. Medication interactions and duplications can be detected and corrected.

  1. You should always keep this form with you.
  2. Take this form to ALL doctor visits and ALL medical testing (lab, x-ray, MRI, CT, etc.) Take this form to ALL pre-assessment visits for admission or surgery and ALL hospital visits (ER, in-patient admission, out-patient visits).
  3. Update this form as changes are made to your medications. Include any home medications. If a medication is stopped, draw a line through it and record the date it was stopped. If help is needed ask your physician, nurse or pharmacist to help you fill out this form.
  4. Tell your family, friends and neighbors about the benefits of using this form.
  5. When you are discharged from the hospital your medications will be reviewed with you. It is important to update your list at this time. When you return to your doctor, take your updated form with you. This will keep everyone up-to-date on your medications.

Make sure your medication list is complete and up to date.

List all medications and dosages: over the counter or home medications, prescriptions, update with new prescriptions.

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