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EDWARD Hospital and Health Services


Medication Tracking

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Always carry a list of the medications (prescription and over-the-counter) and herbal supplements that you routinely take, including the dosage and frequency. Make sure that you share this information with your doctors and nurses. If you brought any of these medications to the hospital with you, please send them home with a loved one or visitor. Don't recognize a medication?  Ask the caregiver to check it before you accept it.

TRACK YOUR MEDICATIONS HERE AT WWW.EDWARD.ORG/MEDCARD:
Use this page to track your medications. Click the printer icon above on the right to print out this medication tracking form and bring this to the hospital on your next visit. We've provided links to additional medication tracking resources below:  

Wallet card: PDF version or Word version (view in Print Layout);
Online resources include http://www.ihealthrecord.org/ and http://www.healthvault.com/.

 Name                                                                                           

 Date of Birth                                                                            
 Allergies (Drug, food, etc.)

 Medical Conditions

 Emergency Contact (name and phone)

 

  Current Medications (RX & Over-the-Counter)

Drug (Brand/Generic Names)  Strength  Directions for Use  Ordering Physician 
       
       
       
       
       
       
       
       
       

  Herbal & Dietary Supplements

SUPPLEMENT
(Herbal,Vitamin, Mineral, etc.)
 STRENGTH

FREQUENCY OF USE 

     
     
     
     
     
     
     
     
     

 




 

(630) 527-3000

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Edward Hospital & Health Services
801 S. Washington, Naperville, IL 60540 • (630) 527-3000

Naperville • Plainfield • Bolingbrook • Oswego • Woodridge
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