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Personal Medication Lists

Who is this for?


If you're part of our Medication Therapy Management program, we might ask you to send us a list of the drugs you're taking. Find the form here.

Our Medication Therapy Management program is for people managing multiple chronic conditions and taking many prescription drugs. It helps you get the best results from your medications.

When you start the program, we'll send you a list of the prescription drugs you're taking based on a conversation we've had with you. You can also fill out one of the blank personal medication lists below and send it to us.

The list helps our pharmacists and qualified pharmacy staff catch any potential problems or gaps. If we find an issue, we'll contact you or your doctor.

You can also use this form to help you and your doctors keep track of the medications you're taking.

Find your personal medication list:

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Page Last Updated Thu Oct 23 10:49:16 EDT 2014