The medicines you take are a very important part of your health information.
Information such as the prescription drug name, strength and directions for taking it will help your physician provide the best care for you.
Please print the
UWMC Patient Medication History Form, fill it out or have a caregiver or family member help you complete it. Please bring the completed list of current medications (and/or your bottles) to your visit and discuss it with your UW Medical Center medical provider.
If you need more space to list your medicines, please copy the form or use a blank piece of paper.