Preview Printable Medication Checklist Sample

Medication dose

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Medication cHecKlist

INSTRUCTIONS: List each medication that you need to take along with the dose. If a medication only has to be taken once a day, list it at the time

your doctor has told you to take it (morning or evening). If a medication has to be taken twice a day, list it under AM and PM. Take a look at the

example to get an idea of how to ﬁll it out. Once you have it ﬁlled out, put it someplace like your refrigerator where you see it every day-- then all

you have to do is check the box for that day when you take your medication.

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