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Get UC Davis Health My Medications List

Armacy: Phone: Other Pharmacy(s) Phone: List All Allergies (Medication or Food) Allergic to: Describe reaction Allergic to: Describe reaction List All Prescription Medications, Over-The-Counter Medicines, Herbal Supplements or Vitamins You Take (continue on second page if needed) This form is available for download or print at http://www.ucdmc.ucdavis.edu/pharmacy/infoforpatients.html As needed Bedtime What time of day do you take the medicine? Dinner How to take (ex: take 1 tablet.

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