Medical Profile Form

First page of Profile, Demographics                                  
Page 2 Medication List
Page 2 Medication List
Extra Page if needed

                                                

Do you ever get tired of repeating the same information over and over, every time you go to a doctor’s appointment?  Do you get frustrated trying to remember the name and, especially, the spelling of the medications you take, how much, and how often you take them, as the nurse waits for you to recall the changes since your last appointment?  If so, I have a tool you will be happy to use. I created this form when I first started taking my husband to appointments multiple times a year. It saves me tons of time and the healthcare professionals LOVE it! All I do, is hand it to them as I walk in the door. The questions stop immediately, and they are finished with us in minutes.  No more struggling to remember dates, names, or amounts. It’s great. 

If you prefer a Microsoft Word version that allows you to type directly into it and update it each time something changes, please send me an email at the address listed at the bottom of the form. I’ll be happy to send you a copy. 

Medical Profile 

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