Caring Pharmacy · 604-553-8880
My medication list
Print, fill in and bring to health appointments. Include prescriptions, non-prescription medicines, vitamins and other supplements, including medicines supplied outside a blister pack.
Name:
Updated on:
Medication allergies and reactions:
| Medicine & strength | Amount & how taken | When / how often | What it is for | Notes & special instructions |
|---|---|---|---|---|
Questions for my pharmacist
This is a personal record, not a prescription or instructions to change your treatment. Update it when medicines change and check it with your pharmacist. Keep the completed list private; do not email personal health information.