Medications Listing (complete prior to office visit)

Your healthcare provider needs an accurate record of all your medications, including prescription drugs, allergy or other injections, over-the-counter medicines, vitamins and other supplements. Please check your medicine bottles, etc. and complete this form prior to your office visit. In addition to current medications, list those you stopped taking and indicate why you did so. The completeness and accuracy of this form will help you and your physician better manage your care. Keep a copy of this list for your records and refer to it when updating the list for future office visits.

The CFIDS Chronicle - Fall 1994