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You
probably already take many medications and keeping track of them is
important. Not only will this be useful for your new doctor, but
you’ll also have a long-term medication record that includes
reactions and costs and a list of medications that worked for you.
For each medication, write down the
name and dosage, when you started taking it, when
you stopped taking it (if applicable), side effects (if any), doctor
who prescribed it and the cost. Tell your doctor if you're allergic to any medications.
Sample medications record form
 Use the
medications record
(pdf)
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Medication and dosage |
Date
begun |
Reason for stopping |
Date stopped |
Prescribed by |
Side effects |
Did it work? Yes/No/Maybe |
Cost |
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Actual |
Covered by insurance |
My cost |
6MP,
75mg/day |
Aug
1999 |
Nauseated,
changed to Asacol |
Jan
2000 |
Dr. Nemo |
Fatigue,
nausea |
Maybe |
$500/
month |
$200 |
$300 |
 
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