AS@W
PCHC Positive Coping with Health Conditions
Medication Information Sheet

Medication Name

Medication Name

Date prescribed

Date prescribed

Prescribing doctor

Prescribing doctor

Why do I need it?

Why do I need it?

When should I take it?

When should I take it?

How much should I take
each time?

How much should I take
each time?

How long do I keep taking it?

How long do I keep taking it?

What should I avoid while using it?

What should I avoid while using it?

What side effects should I report if they happen?

What side effects should I report if they happen?

What should I do if I miss a dose?

What should I do if I miss a dose?

How will I know if the medication is helping?

How will I know if the medication is helping?