Page 21 - BARMC Guide 2017 MOBILE

Use this handy reference guide! Write the name of each medicine you take, why you take it and when. Add new medicine as it is prescribed and mark o medicine if it has been discontinued. Carry this handy reference with you to appointments and hospitalizations. Keep your list updated, ask your healthcare professional(s) to assist you.
Medicine
Date & Reason Taken
Dose & When Taken
Time(s)
Example: Amoxicillin 250mg
5/12/16 Bladder Infection
1 capsule 3 times a day
9 a.m., 12 p.m., 6 p.m.
LWisthalalmteadrse,suypopluemaelnltesrogrfiocodtso? List supplements or foods.
Describe symptoms
This is your chance to ask your
Doctor any questions about your medicines. DON’T BE SHY, ASK THEM WHY!
Your Physicians
Physician:
Phone: Specialty: Physician: Phone: Specialty:
Physician:
Phone: Specialty: Physician: Phone: Specialty:
Over-The-Counter Medicines
o Cold & Flu o Allergy
o Nasal Spray o Aspirin
o Ibuprofen (Advil)
o Tylenol o Vitamins o Diet Pills o Antacid
o Sleep Aid
o Laxative
o Nausea/Diarrhea o Other
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MEDICINE MINDER