Can you name all of the medications you are taking? Do you know what doses you are taking and what the medicine is for?
“My Medicine List™” can help you keep track of everything you take to keep you healthy, including pills, vitamins, and herbs.
Having a list of all your medicines in one place also helps your doctor, pharmacist, hospital, or other healthcare workers take better care of you.
Click here to download your PDF copy of "My Medicine List™." You can then fill out each line electronically, save it to your computer, and print out a copy.
• My Medicine List in Spanish—Mi Lista de Medicamentos
NOTE: This form works best using Internet Explorer. Other browsers may not support it. If you cannot fill out the form electronically using a browser other than Internet Explorer, simply print out the list and fill it in by hand.
My Medicine List™ was developed by ASHP and the ASHP Foundation through a sponsorship from sanofi-aventis.