Keeping Track Of Your Medicines

This chart can help you keep track of the different medicines, vitamins and over-the-counter drugs you take. Because your medications may change over time, make a copy of the blank form 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.

DATE ________________

Name Of Drug
What It's For
Date Started
Doctor Color & Shape
Dose (How Much & How Often)
Instructions
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2.
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For more resources on health and aging, visit: www.NIHSeniorHealth.gov

Last reviewed: September 2014