MY LIST OF CURRENT PRESCRIPTION & OTC MEDICATIONS(Includes ALL prescription and over-the-counter drugs, plus other items* prescribed by any caregiver that are injected, swallowed, inhaled or otherwise applied to my body)Name______________________________ Date list completed_______________________ ------------------ Medications, etc. ------------ Dose or Amount --------- Frequency ---- -> -> -> -> -> -> -> -> -> -> -> -> -> -> *Examples: oxygen, CPAP, skin lotions, eye drops, and any scheduled treatments that may be received in a hospital or physician's office (eg, injections for arthritis, chemotherapy, blood transfusions) |