Talking with Your Doctor

Tracking Your Medications: Worksheet

You may be taking many different medicines as well as numerous vitamins and over-the-counter drugs. It can be confusing to keep track of everything! This form can help. Because your medication regimen may change over time, make a copy of the blank form (PDF, 57K) so you will always have a clean copy to use. Try to bring a completed and updated copy of this form to every doctor appointment.

Name of Drug	What It's For	Date Started	Doctor	Color/Shape	Dose and Instructions

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed: May 19, 2017