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Southcoast Hospitals Group has earned The Joint Commission's Gold Seal of Approval.

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Keep Your List of Medications Current

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Click here to download Your Medication Card (fill-in PDF form)

One of the best ways to play an active role in your own health care is to keep a current list of all the medications and supplements you take.

Medication safety means you will receive the medication prescribed to you — at the right time and in the right way. Your doctor, nurse, pharmacist and other health care providers welcome your involvement in this process.

Southcoast encourages you and your family to download a Medication Record form, complete it on your computer and print it and carry it to every visit or stay with a doctor, emergency room, hospital, rehabilitation facility, nursing home or home health provider.

If you or a family member is unable to complete this list, bring all your medications with you to the doctor to receive help in completing the list.

This form will help promote your health and safety by:

  • Assisting you to discuss your medical history with your doctor.
  • Helping you track your medications, herbal and supplement use.
  • Provide your health care providers with more complete and accurate information so you obtain a safe level of care.

Keeping Your Medication Record Current

Tips for keeping your medication list current:

  • Keep a list of all current medications for every member of your family. Make sure to include non-prescription medicines, vitamins, herbal or natural remedies.
  • Update your list every time you start or stop taking any medications.
  • Show your list to your doctor and pharmacist regularly.
  • Always carry this card with you in your wallet or purse.
  • Keep a copy of this card on your refrigerator so others can find it if you are unable to speak. Emergency responders know to look there.
  • Take your medications only as prescribed and always take the full prescription.
  • Ask your doctor and pharmacist about possible side effects and what to do if you forget to take a dose.
  • Never take someone else’s medicine.

Your Medication Record

This is what the Medication Record card looks like.


  1. Download the PDF form.
  2. Open the document using Adobe Acrobat Reader and type in your information using the fill-in form.
  3. Save the file.
  4. Print out the document and trim and fold it.
  5. Carry in your wallet or purse.

Tip: Copy the document and create a record for every member of your household.


Southcoast wishes to thank the Partnership for Healthcare Excellence and the Massachusetts Coalition for the Prevention of Medical Errors for help in developing this Medication Record card.

Find a Physician: 844-774-5544

Download our FREE MyHealth app for iPhone to help you keep track of your medications.

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