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A free, printable template

Medication list template for an aging parent

One clear, current medication list is the single most useful thing you can bring to a doctor’s visit, an ER, or a new pharmacy. Print this template and fill it in, keep it on the fridge, and bring it to every appointment. Update it whenever a medication changes.

Parent & pharmacy details

Name:  
Date of birth:  
Primary doctor:  
Pharmacy & phone:  
Allergies / reactions:  
List last updated:  

Current medications

Medication Dose / strength When taken What it’s for Prescribing doctor Refill due / pharmacy Notes (with food? side effects?)

Also include over-the-counter medicines, vitamins, supplements, eye drops, inhalers, and creams — they can interact too.

Recent changes

Date:   — Change:  
Date:   — Change:  
Date:   — Change:  

Note what changed and when — “stopped,” “new,” or “dose changed” — so the next doctor sees the history at a glance.

Tips for keeping it accurate

  • Keep one master list and make sure the whole family uses the same one.
  • Update it the day a medication changes — not later, when the details get fuzzy.
  • Snap a photo of each pill bottle label as a backup.
  • Bring the list to every appointment and ask, “Does anything here interact?”
  • Note the reason for each medication — it helps every new doctor understand the whole picture.

Tired of reprinting this every time something changes?

WithUs keeps this medication list live and shareable, so when a dose changes, everyone in the family sees the current list — and you can pull it up on your phone at the pharmacy or the ER without digging through texts.

Create your family’s Care Circle — free

WithUs is not a medical provider and does not sell your family’s care information. This template is for organization and does not replace medical advice. Always follow your doctor’s and pharmacist’s instructions.

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