About the List
Create one clear record before your next visit.
Use this four-page fillable list to keep prescriptions, over-the-counter medications, vitamins, minerals, and other supplements together. Update it when something changes, then bring it to healthcare visits, testing, and procedures.
What it includes
- Twelve prescription rows for the medication, dose or strength, frequency, reason, and prescribing clinician.
- A checkoff table for 18 common over-the-counter medications.
- Separate sections for 18 vitamins and minerals and 18 other supplements or nutrition products.
- Space to record each exact product or form, dose, frequency, and reason or goal.
Use this resource safely
This fillable list supports healthcare conversations but does not replace individualized medical advice. Do not start, stop, or change a medication or supplement solely because of this guide. A pharmacist or qualified clinician can help review questions related to health conditions, pregnancy or breastfeeding, upcoming procedures, or other products you use. For an emergency, call 911 or use the appropriate emergency service in your area.