Page 19 - StLV Guide 2017

Handy Reference: Medications You Are Currently Taking
List all medications you are currently taking (prescription, over-the-counter and vitamin supplements), their name, strength, and dosage. (Example: Haldol-25mg twice a day, Aspirin-12mg daily, Albuterol Inhaler as needed, Zyrtec-10mg as needed, Calcium)
Name Of Medication
Date Started Taking
Dose (How Much You Take)
When You Take
Reason For Taking
What Are You Allergic To? List Any Medications, Supplements or Foods
Describe Symptoms
Medications You Need To Take
After Leaving The Hospital
Use this Medicine Minder to record the names, dosages, and instructions for your new medications you will need to take when you leave the hospital.
This is your chance to ask your
Doctor any questions about your medications. DON’T BE AFRAID TO ASK QUESTIONS UNTIL YOU UNDERSTAND!
Name Of Medication
Reason For Taking
Dose (How Much To Take)
When To Take It?
How to Take It? (on an empty stomach, with food, etc.)
NOTES
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YOUR MEDICINE MINDER