Universal Medication Form
Download the Universal Medication Form
The South Carolina Hospital Association makes this form freely available in both English and Spanish.
Keep Track of Your Medications
Download and keep this handy form in your wallet, pocket or purse.
The Universal Medication Information Form, courtesy of Everypatient.com, enables you to keep a handy, up-to-date record of all medication you are taking, and helps your health care providers prevent chemical conflicts, particuarly in an emergency.
How to Use This Form
- List all prescriptions, over-the-counter medications, vitamins and any herbals you are taking.
- Take this form with you to all doctor visits and diagnostic tests.
- Have your doctor update the form at each visit.
- If you have a medical emergency, take the form with you to the Emergency Room.
- Keep a copy of the form with you at all times.
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