My Medication List
Use the chart below to create a record of your medications. It is important to keep it up-to-date.
Remember to list over-the-counter (non-prescription) medicines and herbal supplements too.
Review it once a year with your health care provider.
Ask your doctor to explain each medicine:
Why you are taking it?
What are the side effects?
How long you can expect to take it?
NAME OF MEDICINE
DIRECTIONS FOR USE
WHY TAKING IT?
Once daily in the morning
Physicians and Providers: Please review this list and instruct the patient on any changes you make.
Provided by LifeWise Health Plan of Oregon and LifeWise Health Plan of Washington.