Get Medication Reconciliation Form Template

The Medication Reconciliation Form Template is essential for ensuring accurate medication management when patients are admitted to a healthcare facility. This guide will provide clear instructions on how to complete the form online effectively, promoting safety and continuity of care.

Follow the steps to fill out the Medication Reconciliation Form Template online.

1. Click the ‘Get Form’ button to obtain the Medication Reconciliation Form Template and open it in the editor.
2. Begin filling out the patient details, including their name and unit number, at the top of the form.
3. In the allergies section, list any known allergies the patient has to medications.
4. Provide a comprehensive list of all medications the patient was taking prior to admission, including over-the-counter and alternative medications. Ensure accuracy as alternative medications will not be continued upon admission.
5. Indicate the source of the medication list by checking all applicable options, which can include the patient’s recall, pharmacy details, and primary care physician list.
6. If this form is an addendum to or revision of a previously completed medication list, check the appropriate box.
7. Indicate whether the patient is pregnant or breastfeeding by circling the appropriate options.
8. For each medication listed, determine whether to continue or discontinue the medication by circling ‘C’ or ‘DC’.
9. Record the medication history with the patient’s verification, including the date it was recorded.
10. Complete the medication details fields: medication name, dose, route, frequency, last dose date/time, and physician order.
11. Review the completed form for accuracy and ensure that all required information is filled out clearly.
12. Once completed, save your changes, and then you can download, print, or share the form as necessary.

Complete your Medication Reconciliation Form Template online to enhance patient safety and care.