PicturePhoto By: Steve Snodgrass
  1. Drug and other allergies
  2. Drugs to which you experienced a negative reaction (couldn't tolerate it)
  3. Name of drug – generic and brand names
  4. Dose
  5. Start and stop dates
  6. What the pill/capsule/liquid looks like
  7.  A record of any side effects experienced
  8. What the drug is treating
  9. How and when to take the medication
  10. What not to do when taking the medication
  11. Over the Counter medications and supplements with their doses
  12. Recently completed prescriptions
  13. Name/contact info of prescribers (physician/physician assistant/nurse practitioner…)
  14. Name/contact info for pharmacy that filled the prescription(s)

Because You Care



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