The Care-Team and Medication Worksheet
Keep this current, and keep a copy on the fridge and a photo on your phone. It goes to every appointment and every emergency.
The person: - Full name and date of birth: ______________________ - Conditions being treated: ______________________ - Allergies and bad reactions: ______________________
Every medication (update the moment anything changes):
| Medicine | Dose | How often | What it's for | Prescribed by | |---|---|---|---|---| | | | | | | | | | | | | | | | | | |
(Include over-the-counter medicines and supplements, they matter too.)
The care team: - Primary doctor, name and number: ______________________ - Specialists, names and numbers: ______________________ - Pharmacy, name and number: ______________________ - Preferred hospital: ______________________
In an emergency: - Call first: ______________________ - Who holds health-care power of attorney: ______________________ - Where the legal documents are kept: ______________________









