To ensure that you receive the best possible care during times of illness, surgery and even wellness, it is important that you be an advocate for yourself. Most patients take medications on a daily basis. It is very important that you know what your medications are, when to take them, and the dose that you take.
Please complete this blank "Current Medication List" in the privacy and quiet of your own home. This list also documents your personal information, your doctors’ names, and the pharmacy where you purchase your medications.
After you complete this list, place it into your wallet or purse so that you will always know what specific medications you are currently taking. Update this list each time your doctor changes your medication and/or the dose.
Always bring your list to each doctor’s appointment and to the hospital whenever you are having surgery.
Thank you for taking part in your personal medical care by providing this vital, updated information about yourself.
This form is provided in pdf format and can be downloaded directly to your computer.
Right click to download and save on your computer. Then print out and complete the form.
- Always keep this form with you.
- 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, outpatient visits).
- Update this form as changes are made to your medications. When a medication is stopped, draw a line through it and record the date it was stopped. If help is needed, ask a physician, nurse, or pharmacist to help you fill out this form.
- Tell your family, friends and neighbors about the benefits of using this form.
- When you are discharged from the hospital, you will get an updated list of your medications. This will be reviewed with you and you will be given a copy. When you return to your doctor, take your updated list with you. Always keep this form with you. This will keep everyone up-to-date on your medications.
By using a current medication list and keeping it updated, you:
- Reduce confusion and save time.
- It helps you remember your medications.
- Improve communications.
- Provide doctors, health care providers and institutions with a current list of ALL of your medications.
- You and/or your family member know exactly what medications are to be taken and when.
- Improve medication safety. Medication interactions and duplications can be detected and corrected.
An alternative to the current medication list that is provided, here is a website that helps you to build your list and emails it to you. Note: This link is not a Mass. Eye and Ear page: MACoalition Consumer Directory
More About Your Medications
In addition to the medication list, we have provided a link to Medline Plus, a web page developed by the National Institutes of Health, which you can use as a resource for information on various medications: Medline Plus
Under the heading, “Drug Information,” you may search for prescription and over-the-counter medication. Drugs are listed alphabetically by the first letter of their generic name or brand name. Once you have found the name of a drug, you may click that name for additional information, such as reasons the drug is prescribed, side effects, dietary precautions, and more.
Please note that this web page is provided as an informational resource only. You should not take any medication without the guidance, advice and supervision of a physician or medical professional.
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