HAIL Medication List
Print this webpage to use the list, or use it as you make your own.
Name of Consumer ___________________________________
Name of ILS ________________________________________
Date of Visit _________________________________________
| Time of Day | Name of Drug | Dose | How I take it? (how much, how | Health Condition (Why I take it?) | Who told me to take it? |
|---|---|---|---|---|---|
| Morning | |||||
| Afternoon | |||||
| Evening | |||||
| Night | |||||
| Medicines I use on an as needed basis | |||||
Notes: