Medication List Template

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Medication List
How to use the Medication List (MedList):
This list can help you and your family keep track of everything you take to keep you healthy—your pills, vitamins, and herbs. Having all your medications listed in one
place helps your doctor, pharmacist, hospital, or other healthcare providers take better care of you. Start using the MedList today!
1. If you need help filling out the MedList, ask a family member, friend, or a healthcare provider to help you.
2. Before filling in the list, collect all the medications you take, including patches, inhalers, eye/ear/nose drops, creams, ointments, and samples of medication. Include
anything you may take, such as: over-the-counter medication, vitamins, minerals, herbal products, or recreational drugs (for example, alcohol or marijuana).
3. Write down the following for each medication you take:
a) The name (example: Tylenol®, also known as acetaminophen)
b) The dose (example: 500 mg or 1000 IU)
c) How much (example: 1 pill, 3 drops, or 2 puffs)
d) How often and what time of day you take the medication (example: 1 pill a day, in the morning, or 1 time per week)
e) Reason for taking the medication (example: arthritis)
f) For any additional information, such as: who prescribed the medication (example: my family doctor).
Here’s an example:
Name of medication
Dose
How much
How often and when
Why I take it
Additional Information
Morning
Afternoon
Evening
Bedtime As Needed
Example: atorvastatin
20 mg
1 pill
To lower cholesterol
Prescribed by Dr. Goodheart
4. Keep this list with you at all times. Keep it in your wallet or purse so it is available when you need it.
5. Take this list and share it when you visit the doctor, pharmacist, have a medical appointment or test, or have to go to the hospital.
6. Whenever you stop taking something, start taking something new, have a change in the strength or how much you take, be sure to update your MedList, including
the date you make the changes.
7. Contact your doctor or pharmacist if you have any questions regarding the medications you are taking.
To find out more, visit
If it’s on the list, it won’t be missed
1-866-408-5465 (LINK)
or call Health Link Alberta:
toll-free.

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